Neuropsychological Correlates of Anosognosia for Objective Functional Difficulties in Older Adults on the Mild Cognitive Impairment Spectrum.

Content Provider	Europe PMC
Author	Steward, Kayla A Bull, Tyler P Kennedy, Richard Crowe, Michael Wadley, Virginia G
Copyright Year	2019
Abstract	Abstract Objective To examine the neuropsychological correlates of anosognosia for instrumental activities of daily living (IADLs) in older adults with mild cognitive impairment (MCI) and mild dementia. Method Participants (n = 103; age range = 54–88, 52% female) with MCI and mild dementia were recruited from neurology and geriatrics clinics for cross-sectional analysis. They completed neuropsychological tests along with subjective and performance-based assessments of six IADLs: financial management, driving, grocery shopping, nutrition evaluation, telephone use, and medication management. For each IADL, participants were classified as having anosognosia when there was objective difficulty but no subjective complaints. Results Depending on functional domain, 13–39% of the sample had objective IADL difficulty, and of those, 65–93% lacked insight into these deficits. Binomial logistic regression models controlling for demographic variables revealed that measures of global cognition, executive function, visual attention, and verbal memory predicted classification of anosognosia, and these relationships varied across IADLs. In contrast, basic auditory attention, working memory, depressive symptoms, nor cognitive reserve were significantly related to anosognosia for any IADL. Conclusion Results support the Conscious Awareness Model, which theorizes that accurate metacognitive output is reliant on attentional, memory, and executive functioning systems. Findings from this study suggest that anosognosia for different IADLs may arise from breakdowns at varying points in this model, explaining both inter- and intra-patient variability in self-awareness of functional deficits.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7244883&blobtype=pdf
Page Count	12
ISSN	08876177
Volume Number	35
DOI	10.1093/arclin/acz065
PubMed Central reference number	PMC7244883
Issue Number	4
PubMed reference number	31875876
Journal	Archives of Clinical Neuropsychology [Arch Clin Neuropsychol]
e-ISSN	18735843
Language	English
Publisher	Oxford University Press
Publisher Date	2020-05-01
Access Restriction	Open
Rights License	This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.
Subject Keyword	Mild cognitive impairment dementia instrumental activities of daily living anosognosia neuropsychology
Content Type	Text
Resource Type	Article
Subject	Neuropsychology and Physiological Psychology Clinical Psychology Psychiatry and Mental Health