![]() ![]() This includes different types of anosognosia, including: (1) Primary anosognosia, where there is either a breakdown in connectivity, leading to impairments in bottom-up integration, or top-down modulation (2) Executive anosognosia, which involves dysfunction of higher-level monitoring abilities that lead to impaired self appraisal and performance evaluation and (3) Mnemonic anosognosia, in which lack of awareness is caused by specific types of memory impairment. Our formulation has been the Cognitive Awareness Model (CAM Agnew and Morris, 1998 Morris and Hannesdottir, 2004 Morris and Mograbi, 2013), where lack of explicit awareness is thought to be the result of cognitive impairments at different levels, with anosognosia being characterized by its heterogeneity. The manner in which the neurocognitive mechanisms supporting awareness are damaged in AD has been elucidated by experimental studies and theoretical formulations. In addition, loss of awareness has been linked to greater burden in relatives or caregivers ( Seltzer et al., 1997 Verhülsdonk et al., 2013). This has been shown to be associated with earlier institutionalization ( Horning et al., 2014) worse prognosis ( Orfei et al., 2007), reduced treatment compliance ( Patel and Prince, 2001), and higher exposure to dangerous behaviors ( Starkstein et al., 2007). Whilst anosognosia is more generally defined as lack of awareness about neurological impairment or illness, it also can be applied specifically to Alzheimer’s disease (AD), in which patients are frequently unaware of their cognitive deficits and the consequences of their clinical condition ( Mograbi et al., 2009, 2012 Mograbi and Morris, 2018). Finally, wider consequences of this metaphor for the understanding of selfhood in dementia are discussed. In particular, focus is given to empirical evidence produced on anterograde memory deficits about performance, the profile of autobiographical retrograde memory loss and the role of frontal lobes in anosognosia in AD. In the current review, evidence from the past 10 years in relation to this concept is critically appraised. This potentially outdated sense of self has been named, as a metaphor, the petrified self. It has been hypothesized that memory disorder may be a key contributing factor to anosognosia, with people with AD not being able to update their personal information about performance and relying on older consolidated material about ability. ![]() Lack of awareness about disease, its symptoms and consequences, also termed anosognosia, is a common feature of Alzheimer’s disease (AD). 2Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom.1Department of Psychology, Pontifícia Universidade Católica, Rio de Janeiro, Brazil. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |