Anosognosia Could Predict Alzheimer Disease
Anosognosia, the impaired ability of an individual to perceive their illness, is associated with increased risk of progression to dementia, a new study found.
For their study, the researchers assessed 468 patients with amnestic mild cognitive impairment. Patients were categorized based on awareness, which was determined by the discrepancy between the patient and the informant score on the Everyday Cognition questionnaire.
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Using Voxel-based linear regression models, the researchers investigated the association between self-awareness status and baseline β-amyloid load (measured by [18F]florbetapir) and the relationship between awareness status and regional brain glucose metabolism (measured by [18F]fluorodeoxyglucose) at baseline and at 24-month follow-up.
In addition, the association between awareness status and conversion from amnestic mild cognitive impairment to dementia was examined via multivariate logistic regression.
Ultimately, findings revealed that the likelihood of conversion to dementia within 2 years was nearly 3-fold higher in patients with impaired awareness. The researchers observed that patients with impaired awareness had decreased [18F]fluorodeoxyglucose uptake and increased [18F]florbetapir uptake in the posterior cingulate cortex at baseline.
“Our results suggest that anosognosia is linked to Alzheimer disease pathophysiology in vulnerable structures, and predicts subsequent hypometabolism in the default mode network, accompanied by an increased risk of progression to dementia,” the researchers concluded. “This highlights the importance of assessing awareness of cognitive decline in the clinical evaluation and management of individuals with amnestic mild cognitive impairment.”
—Christina Vogt
Reference:
Therriault J, Ng KP, Pascoal TA, et al. Anosognosia predicts default mode network hypometabolism and clinical progression to dementia [Published online February 14, 2018]. Neurology. https://doi.org/10.1212/WNL.0000000000005120.