scholarly journals Anosognosia in People with Cognitive Impairment: Association with Cognitive Deficits and Behavioral Disturbances

2015 ◽  
Vol 5 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Antonella De Carolis ◽  
Virginia Cipollini ◽  
Valentina Corigliano ◽  
Anna Comparelli ◽  
Micaela Sepe-Monti ◽  
...  

Aims: To investigate, in a group of subjects at an early stage of cognitive impairment, the relationship between anosognosia and both cognitive and behavioral symptoms by exploring the various domains of insight. Methods: One hundred and eight subjects affected by cognitive impairment were consecutively enrolled. The level of awareness was evaluated by means of the Clinical Insight Rating Scale (CIRS). Psychiatric symptoms were evaluated using the Italian version of the Neuropsychiatric Inventory (NPI), whereas memory (memory index, MI) and executive (executive index, EI) functions were explored using a battery of neuropsychological tests and qualified by means of a single composite cognitive index score for each function. Results: A significant positive correlation between the total NPI score and global anosognosia score was found. Furthermore, both the MI and EI scores were lower in subjects with anosognosia than in those without anosognosia (p < 0.001 and p < 0.007, respectively). When the single domains of the CIRS were considered, anosognosia of reason of visit correlated with the EI score (r = -0.327, p = 0.01) and night-time behavioral disturbances (r = 0.225; p = 0.021); anosognosia of cognitive deficit correlated with depression (r = -0.193; p = 0.049) and the MI score (r = -0.201; p = 0.040); anosognosia of functional deficit correlated with the MI score (r = -0.257; p = 0.008), delusions (r = 0.232; p = 0.015) and aberrant motor behavior (r = 0.289; p = 0.003); anosognosia of disease progression correlated with the MI score (r = -0.236; p = 0.015), agitation (r = 0.247; p = 0.011), aberrant motor behavior (r = 0.351; p = 0.001) and night-time behavioral disturbances (r = 0.216; p = 0.027). Conclusions: Our study suggests that, in the early stage of cognitive impairment, anosognosia is associated with both cognitive deficits and behavioral disorders according to the specific functional anatomy of the symptoms.

2020 ◽  
Vol 81 (04) ◽  
pp. 362-367 ◽  
Author(s):  
Karolina Kwiatkowska ◽  
Magdalena Dębicka ◽  
Agnieszka Maryniak ◽  
Stanisław Kwiatkowski

AbstractThis report discusses the relationship between arachnoid cysts (ACs) and cognitive deficits, and we ask if cognitive impairments could justify neurosurgical treatment. In clinical practice, only AC patients with symptoms of intracranial hypertension or focal neurological deficits are referred to surgery. Occasionally, one might assume that nonspecific problems such as impairment of learning, speech, or cognitive functions are caused by an AC and can be improved by surgery. We describe three patients, in which surgery was indicated on the basis of clinical symptoms such as headaches and the size of the cysts. A neuropsychological examination before AC surgery revealed reduced cognitive potential, and the same examination repeated after surgery showed improvement. We have not found any other reason for this change, except for the decompression of the AC.


2020 ◽  
Vol 78 (2) ◽  
pp. 673-681
Author(s):  
Jianjun Wang ◽  
Hanqing Lyu ◽  
Jianxiang Chen ◽  
Songjun Lin ◽  
Haotao Zheng ◽  
...  

Background: Late-life depression often coexists with vascular cognitive impairment and affects the quality of life for elders. However, little is known about cortical morphometric interactions between subcortical vascular mild cognitive impairment (svMCI) and concomitant mild depressive symptoms at the early stage. Objective: We aimed to investigate cortical alterations of svMCI with and without depressive symptoms and determine whether these parameters are associated with depression symptoms and/or cognitive impairments. Methods: Surface based morphometry was performed on 18 svMCI patients with depressive symptoms (svMCI + D), 16 svMCI patients without depressive symptoms (svMCI–D), and 23 normal controls (NC). Results: Compared to NC, both svMCI + D and svMCI–D patients exhibited significantly decreased surface area (SA) in many cortical areas. Interestingly, svMCI + D patients showed significantly increased rather than decreased SA in right lateral occipital gyrus (LOG.R), and a consistent trend of increased SA in these areas compared to svMCI–D. In addition, the svMCI + D showed increased gray matter volume of left pericalcarine (periCAL.L) than svMCI–D, whereas svMCI–D showed decreased gray matter volume of periCAL.L than NC. Further correlation analyses revealed that the SA of left superior temporal gyrus (STG.L) and right lateral orbital part of frontal gyrus (lorbFG.R) were significantly correlated with Hamilton depression rating scale of svMCI + D. Conclusion: In conclusion, these results extend our insight into svMCI and add weight to reevaluation of concomitant early stage depressive symptoms. Moreover, we suggest that LOG.R∖periCAL.L∖STG.L∖lorbFG.R might serve as sensitive and trait-dependent biomarkers to detect concomitant depressive symptoms in svMCI patients.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Meena Gupta ◽  
Abhijit Dasgupta ◽  
Geeta Anjum Khwaja ◽  
Debashish Chowdhury ◽  
Yogesh Patidar ◽  
...  

Background.Behavioural and psychological symptoms of dementia (BPSD) cause significant patient and caregiver morbidity in vascular cognitive impairment (VCI).Objectives. To study and compare the occurrence and severity of BPSD between multi-infarct dementia (MID), subcortical ischaemic vascular disease (SIVD), and strategic infarct subtypes of poststroke VCI and to evaluate the relationship of these symptoms with the severity of cognitive impairment.Methods. Sixty patients with poststroke VCI were classified into MID, SIVD, and strategic infarct subtypes. BPSD were studied by the neuropsychiatric inventory (NPI). The severity of cognitive impairment was evaluated by the clinical dementia rating scale (CDR).Results. 95% of cases had at least one neuropsychiatric symptom, with depression being the commonest, irrespective of subtype or severity of VCI. Strategic infarct patients had the lowest frequency of all symptoms. SIVD showed a higher frequency and severity of apathy and higher total NPI scores, compared to MID. Apathy and appetite disturbances occurred more commonly with increasing CDR scores. The total NPI score correlated positively with the CDR score.Conclusion. Depression was the commonest neuropsychiatric symptom in VCI. The neuropsychiatric profiles of MID and SIVD were similar. The frequency and severity of apathy and the net burden of BPSD increased with increasing cognitive impairment.


2004 ◽  
Vol 16 (1) ◽  
pp. 51-60 ◽  
Author(s):  
Yonas E. Geda ◽  
Glenn E. Smith ◽  
David S. Knopman ◽  
Bradley F. Boeve ◽  
Eric G. Tangalos ◽  
...  

Background: There is inadequate information regarding the neuropsychiatric aspect of Mild Cognitive Impairment (MCI).Objective: To determine the neuropsychiatric profile of MCI, and compare this with normal controls and patients with mild Alzheimer's Disease (AD).Design: Cross-sectional assessment of psychiatric symptoms in subjects that are enrolled in Mayo Clinic's longitudinal study of normal aging, MCI and dementia.Methods and Participants: The Neuropsychiatric Inventory (NPI) was administered to normal control subjects, MCI subjects and patients with early AD. Individual NPI domain scores and total NPI scores were compared among the three groups after controlling for age, educational status, Dementia Rating Scale (DRS) and Mini-Mental State Examination (MMSE) scores. Statistical analysis was performed by utilizing ANOVA, χ2 and Fisher's exact test.Results: Data were analyzed on 514 normal controls, 54 MCI subjects, and 87 subjects with mild AD (CDR of 0.5 or 1); females consisted of 60.3%, 53.7% and 57.5%; and, the average ages (SD) were 77.8 (1.95), 79 (4.6), 80.5 (14.6) respectively. ANOVA pair-wise comparison revealed that both MMSE and DRS differences among the three groups were significantly different at (p=0.05). The total NPI scores were significantly different (p=0.0001, F=107.93) among the three groups using ANOVA. Pair-wise comparison of individual behavioral domain of NPI showed statistically significant differences between MCI and normals; and MCI and AD (p=0.001). Group differences on NPI remained after controlling for age and education at p=0.0375 and p=0.0050 respectively.Conclusion: The neuropsychiatric pattern is reminiscent of the clinical, neuroimaging and neuropsychological profile of MCI. It gives further credence to the view that MCI is indeed the gray zone, with overlap on both ends of the pole.


1978 ◽  
Vol 133 (5) ◽  
pp. 457-460 ◽  
Author(s):  
A. H. Pattie ◽  
C. J. Gilleard

SummaryAssessment of cognitive and behavioural disability on 100 elderly psychiatric admissions was carried out by means of the Clifton Assessment Schedule and the Shortened Stockton Geriatric Rating Scale. The results provided useful predictive indices, confirming the relationship between cognitive impairment and unfavourable outcome at two-year follow up.


Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1951 ◽  
Author(s):  
Ai Kimura ◽  
Taiki Sugimoto ◽  
Kazuya Kitamori ◽  
Naoki Saji ◽  
Shumpei Niida ◽  
...  

We examined the nutritional status and its association with behavioral psychiatric symptoms of dementia (BPSD) among 741 memory clinic patients (normal cognition (NC), 152; mild cognitive impairment (MCI), 271; early-stage Alzheimer disease (AD), 318). Nutritional status and BPSD were assessed using the Mini Nutritional Assessment Short-Form (MNA-SF) and the Dementia Behavior Disturbance Scale (DBD), respectively. Compared to subjects with NC, more subjects with MCI and early-stage AD were at risk of malnutrition (MNA-SF, 8–11: NC, 34.2%; MCI, 47.5%; early-stage AD, 53.8%) and were malnourished (MNA-SF, 0–7: NC, 4.6%; MCI, 5.9%; early-stage AD, 8.2%). Among patients with MCI or early-stage AD, those at risk of/with malnutrition showed higher DBD scores than those well-nourished (12.7 ± 9.0 vs. 9.5 ± 7.3; p < 0.001). Moreover, analysis of covariance adjusting for confounders showed that nutritional status was significantly associated with specific BPSD, including “verbal aggressiveness/emotional disinhibition” (F = 5.87, p = 0.016) and “apathy/memory impairment” (F = 15.38, p < 0.001), which were revealed by factor analysis of DBD. Our results suggest that malnutrition is common among older adults with mild cognitive decline, and possibility that nutritional problems are associated with individual BPSD.


2021 ◽  
Vol 14 ◽  
Author(s):  
Xing-Jie Peng ◽  
Gang-Rui Hei ◽  
Ran-Ran Li ◽  
Ye Yang ◽  
Chen-Chen Liu ◽  
...  

Background: Cognitive impairment is one of the core symptoms of schizophrenia, which is considered to be significantly correlated to prognosis. In recent years, many studies have suggested that metabolic disorders could be related to a higher risk of cognitive defects in a general setting. However, there has been limited evidence on the association between metabolism and cognitive function in patients with early-stage schizophrenia.Methods: In this study, we recruited 172 patients with early-stage schizophrenia. Relevant metabolic parameters were examined and cognitive function was evaluated by using the MATRICS Consensus Cognitive Battery (MCCB) to investigate the relationship between metabolic disorder and cognitive impairment.Results: Generally, the prevalence of cognitive impairment among patients in our study was 84.7% (144/170), which was much higher than that in the general population. Compared with the general Chinese setting, the study population presented a higher proportion of metabolic disturbance. Patients who had metabolic disturbance showed no significant differences on cognitive function compared with the other patients. Correlation analysis showed that metabolic status was significantly correlated with cognitive function as assessed by the cognitive domain scores (p &lt; 0.05), while such association was not found in further multiple regression analysis.Conclusions: Therefore, there may be no association between metabolic disorder and cognitive impairment in patients with early-stage schizophrenia.Trial Registration: Clinicaltrials.gov, NCT03451734. Registered March 2, 2018 (retrospectively registered).


2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaojuan Dan ◽  
Yang Hu ◽  
Junyan Sun ◽  
Linlin Gao ◽  
Yongtao Zhou ◽  
...  

Background: Cognitive impairment is one of the most prominent non-motor symptoms in Parkinson's disease (PD), due in part to known cerebellar dysfunctions. Furthermore, previous studies have reported altered cerebellar functional connectivity (FC) in PD patients. Yet whether these changes are also due to the cognitive deficits in PD remain unclear.Methods: A total of 122 non-dementia participants, including 64 patients with early PD and 58 age- and gender-matched elderly controls were stratified into four groups based on their cognitive status (normal cognition vs. cognitive impairment). Cerebellar volumetry and FC were investigated by analyzing, respectively, structural and resting-state functional MRI data among groups using quality control and quantitative measures. Correlation analysis between MRI metrics and clinical features (motor and cognitive scores) were performed.Results: Compared to healthy control subjects with no cognitive deficits, altered cerebellar FC were observed in early PD participants with both motor and cognitive deficits, but not in PD patients with normal cognition, nor elderly subjects showing signs of a cognitive impairment. Moreover, connectivity between the “motor” cerebellum and SMA was positively correlated with motor scores, while intracerebellar connectivity was positively correlated with cognitive scores in PD patients with cognitive impairment. No cerebellar volumetric difference was observed between groups.Conclusions: These findings show that altered cerebellar FC during resting state in early PD patients may be driven not solely by the motor deficits, but by cognitive deficits as well, hence highlighting the interplay between motor and cognitive functioning, and possibly reflecting compensatory mechanisms, in the early PD.


2021 ◽  
Vol 3 (1) ◽  
pp. 149-154
Author(s):  
Fithry Rahma

Mild cognitive impairment (MCI) is a stage of aging that occurs between normal aging and dementia (precedes dementia). Patients with MCI have memory loss who is otherwise functioning normally and does not match the clinical diagnosis criteria for dementia.  MCI is frequently accompanied by cognitive deficits and non-cognitive. One of the most frequent non-cognitive deficiencies is depression. Depression and mild cognitive impairment are closely associate particularly in the elderly and can progress into neurodegenerative disorders like dementia. This indicates that there is a connection that needs to be explored further. Through this review article, a theoretical review of the relationship between MCI with depression and its conversion to dementia.


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