Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T00:54:57.413Z Has data issue: false hasContentIssue false
  • English
  • Français

On the Relation among Mood, Apathy, and Anosognosia in Alzheimer's Disease

Published online by Cambridge University Press:  13 December 2013

Daniel C. Mograbi  and
Robin G. Morris
Daniel C. Mograbi*
Affiliation:
Department of Psychology, King's College London, London Department of Psychology, Pontifícia Universidade Católica – Rio, Rio de Janeiro, RJ
Robin G. Morris
Affiliation:
Department of Psychology, King's College London, London
*
Correspondence and reprint requests to: Daniel C. Mograbi, Institute of Psychiatry, KCL, PO Box 078, De Crespigny Park, SE5 8AF, London, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This review explores the relationships between depression, apathy, and anosognosia in Alzheimer's disease. Depressed mood is found to be associated with less anosognosia, while greater apathy is associated with more anosognosia, and the contrasting reasons for these associations are discussed. The review also describes recent research findings indicating a dissociation between impaired awareness of condition/deficit and preserved emotional reactivity in response to illness-related material or the experience of failure in tests. We conclude by pointing to future directions for this area of research and clinical implications. (JINS, 2014, 20, 2–7)

Keywords

AwarenessAnosognosiaDementiaAlzheimer's diseaseDepressionApathy
Type
Short Review
Information
Journal of the International Neuropsychological Society , Volume 20 , Issue 1 , January 2014 , pp. 2 - 7
Copyright
Copyright © The International Neuropsychological Society 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aalten, P., Van Valen, E., Clare, L., Kenny, G., Verhey, F. (2005). Awareness in dementia: A review of clinical correlates. Aging & Mental Health, 9, 414–422.Google Scholar
Aalten, P., Van Valen, E., de Vugt, M.E., Lousberg, R., Jolles, J., Verhey, F.R.J. (2006). Awareness and behavioral problems in dementia patients: A prospective study. International Psychogeriatrics, 18, 3–17.Google Scholar
Amanzio, M., Torta, D.M., Sacco, K., Cauda, F., D'Agata, F., Duca, S., Geminiani, G.C. (2011). Unawareness of deficits in Alzheimer's disease: Role of the cingulate cortex. Brain, 134, 1061–1076.Google Scholar
Apostolova, L.G., Akopyan, G.G., Partiali, N., Steiner, C.A., Dutton, R.A., Hayashi, K.M., Thompson, P.M. (2007). Structural correlates of apathy in Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 24, 91–97.Google Scholar
Cacciari, C., Moraschi, M., Di Paola, M., Cherubini, A., Orfei, M.D., Giove, F., Spalletta, G. (2010). White matter microstructure and apathy level in amnestic mild cognitive impairment. Journal of Alzheimer's Disease, 20(2), 501–507.Google Scholar
Caraci, F., Copani, A., Nicoletti, F., Drago, F. (2010). Depression and Alzheimer's disease: Neurobiological links and common pharmacological targets. European Journal of Pharmacology, 626, 64–71.Google Scholar
Clare, L., Nelis, S.M., Martyr, A., Roberts, J., Whitaker, C.J., Markova, I., Morris, R.G. (2011). The influence of psychological, social and contextual factors on the expression and measurement of awareness in early-stage dementia: Testing a biopsychosocial model. International Journal of Geriatric Psychiatry, 27, 167–177.CrossRefGoogle ScholarPubMed
Clare, L., Wilson, B.A., Breen, K., Hodges, J.R. (1999). Errorless learning of face-name associations in early Alzheimer's disease. Neurocase, 5, 37–46.Google Scholar
Derouesne, C., Thibault, S., Lagha-Pierucci, S., Baudouin-Madec, V., Ancri, D., Lacomblez, L. (1999). Decreased awareness of cognitive deficits in patients with mild dementia of the Alzheimer type. International Journal of Geriatric Psychiatry, 14, 1019–1030.Google Scholar
Dietch, J.T., Hewett, L.J., Jones, S. (1989). Adverse effects of reality orientation. Journal of the American Geriatrics Society, 37, 974–976.Google Scholar
Hahn, C., Lim, H.K., Won, W.Y., Ahn, K.J., Jung, W.S., Lee, C.U. (2013). Apathy and white matter integrity in Alzheimer's disease: A whole brain analysis with tract-based spatial statistics. PLoS One, 8(1), e53493.Google Scholar
Harwood, D.G., Sultzer, D.L., Wheatley, M.V. (2000). Impaired insight in Alzheimer disease: Association with cognitive deficits, psychiatric symptoms, and behavioral disturbances. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 13, 83–88.Google Scholar
Harwood, D.G., Sultzer, D.L., Feil, D., Monserratt, L., Freedman, E., Mandelkern, M.A. (2005). Frontal lobe hypometabolism and impaired insight in Alzheimer disease. The American Journal of Geriatric Psychiatry, 13, 934–941.Google Scholar
Kaplan-Solms, K., Solms, M. (2000). Clinical studies in neuro-psychoanalysis: Introduction to a depth neuropsychology. London: Karnac.Google Scholar
Kim, J.W., Lee, D.Y., Choo, I.H., Seo, E.H., Kim, S.G., Park, S.Y., Woo, J.I. (2011). Microstructural alteration of the anterior cingulum is associated with apathy in Alzheimer's disease. American Journal of Geriatric Psychiatry, 19(7), 644–653.Google Scholar
LeDoux, J.E. (1996). The emotional brain: The mysterious underpinnings of emotional life. New York, NY: Simon & Schuster.Google Scholar
Lopez, O.L., Becker, J.T., Somsak, D., Dew, M.A., DeKosky, S.T. (1994). Awareness of cognitive deficits and anosognosia in probable Alzheimer's disease. European Neurology, 34, 277–282.Google Scholar
Lyketsos, C.G., Olin, J. (2002). Depression in Alzheimer's disease: Overview and treatment. Biological Psychiatry, 52, 243–252.Google Scholar
Mangone, C.A., Hier, D.B., Gorelick, P.B., Ganellen, R.J. (1991). Impaired insight in Alzheimer's disease. Journal of Geriatric Psychiatry and Neurology, 4, 189–193.Google Scholar
Marin, R.S., Biedrzycki, R.C., Firinciogullari, S. (1991). Reliability and validity of the Apathy Evaluation Scale. Psychiatry Research, 38, 143–162.Google Scholar
Marshall, G.A., Fairbanks, L.A., Tekin, S., Vinters, H.V., Cummings, J.L. (2006). Neuropathologic correlates of apathy in Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 21, 144–147.Google Scholar
Martyr, A., Clare, L., Nelis, S.M., Roberts, J.L., Robinson, J.U., Roth, I., Morris, R.G. (2011). Dissociation between implicit and explicit manifestations of awareness in early stage dementia: Evidence from the emotional Stroop effect for dementia-related words. International Journal of Geriatric Psychiatry, 26, 92–99.Google Scholar
Michon, A., Deweer, B., Pillon, B., Agid, Y. (1994). Relation of anosognosia to frontal lobe dysfunction in Alzheimer's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 57, 805–809.Google Scholar
Migliorelli, R., Teson, A., Sabe, L., Petracca, G., Petracchi, M., Leiquarda, R., Starkstein, S.E. (1995). Anosognosia in Alzheimer's disease: A study of associated factors. Journal of Neuropsychiatry and Clinical Neurosciences, 7, 338–344.Google Scholar
Mograbi, D.C., Brown, R.G., Morris, R.G. (2012). Emotional reactivity to film material in Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 34, 351–359.Google Scholar
Mograbi, D.C., Brown, R.G., Salas, C.R., Morris, R.G. (2012). Emotional reactivity and awareness of task performance in Alzheimer's disease. Neuropsychologia, 50, 2075–2084.Google Scholar
Mograbi, D.C., Ferri, C.P., Sosa, A.L., Stewart, R., Laks, J., Brown, R.G., Morris, R.G. (2012). Unawareness of memory impairment in dementia: A population-based study. International Psychogeriatrics, 24, 931–939.Google ScholarPubMed
Moro, V., Pernigo, S., Zapparoli, P., Cordioli, Z., Aglioti, S.M. (2011). Phenomenology and neural correlates of implicit and emergent motor awareness in patients with anosognosia for hemiplegia. Behavioral Brain Research, 225, 259–269.Google ScholarPubMed
Morris, R.G., Brookes, R. (2012). Neuropsychological assessment of older adults. In L.H. Goldstein & J.E. McNeil (Eds.). Clinical Neuropsychology: A Practical Guide to Assessment for Clinicians. John Wiley & Sons.Google Scholar
Morris, R.G., Hannesdottir, K. (2004). Loss of ‘awareness’ in Alzheimer's disease. In R. G. Morris & J. T. Becker (Eds.), The cognitive neuropsychology of Alzheimer's disease (pp. 275–296). Oxford: Oxford University Press.Google Scholar
Morris, R.G., Mograbi, D.C. (2013). Anosognosia, autobiographical memory and self knowledge in Alzheimer's disease. Cortex, 49(6), 1553–1565.Google Scholar
Orfei, M.D., Varsi, A.E., Blundo, C., Celia, E., Casini, A.R., Caltagirone, C., Spalletta, G. (2010). Anosognosia in mild cognitive impairment and mild Alzheimer's disease: Frequency and neuropsychological correlates. The American Journal of Geriatric Psychiatry, 18, 1133–1140.Google Scholar
Ota, M., Sato, N., Nakata, Y., Arima, K., Uno, M. (2012). Relationship between apathy and diffusion tensor imaging metrics of the brain in Alzheimer's disease. International Journal of Geriatric Psychiatry, 27(7), 722–726.Google Scholar
Ott, B.R., Noto, R.B., Fogel, B.S. (1996). Apathy and loss of insight in Alzheimer's disease: A SPECT imaging study. The Journal of Neuropsychiatry and Clinical Neurosciences, 8, 41–46.Google Scholar
Reed, B.R., Jagust, W.J., Coulter, L. (1993). Anosognosia in Alzheimer's disease: Relationships to depression, cognitive function, and cerebral perfusion. Journal of Clinical and Experimental Neuropsychology, 15, 231–244.Google Scholar
Rosen, H.J. (2011). Anosognosia in neurodegenerative disease. Neurocase, 17, 231–241.Google Scholar
Seltzer, B., Vasterling, J.J., Hale, M.A., Khurana, R. (1995). Unawareness of memory deficit in Alzheimer's disease: Relation to mood and other disease variables. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 8, 176–181.Google Scholar
Spalletta, G., Girardi, P., Caltagirone, C., Orfei, M.D. (2012). Anosognosia and neuropsychiatric symptoms and disorders in mild Alzheimer disease and mild cognitive impairment. Journal of Alzheimer's disease: JAD, 29(4), 761–772.Google Scholar
Starkstein, S.E., Brockman, S., Bruce, D., Petracca, G. (2010). Anosognosia is a significant predictor of apathy in Alzheimer's disease. Journal of Neuropsychiatry and Clinical Neurosciences, 22, 378–383.Google Scholar
Starkstein, S.E., Ingram, L., Garau, M.L., Mizrahi, R. (2005). On the overlap between apathy and depression in dementia. Journal of Neurology, Neurosurgery, and Psychiatry, 76, 1070–1074.Google Scholar
Starkstein, S.E., Jorge, R., Mizrahi, R., Adrian, J., Robinson, R.G. (2007). Insight and danger in Alzheimer's disease. European Journal of Neurology, 14, 455–460.Google Scholar
Starkstein, S.E., Petracca, G., Chemerisnki, E., Kremer, J. (2001). Syndromic validity of apathy in Alzheimer's disease. The American Journal of Psychiatry, 158, 872–877.Google Scholar
Starkstein, S.E., Sabe, L., Chemerinski, E., Jason, L., Leiguarda, R. (1996). Two domains of anosognosia in Alzheimer's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 61, 485–490.Google Scholar
Troisi, A., Pasini, A., Gori, G., Sorbi, T., Baroni, A., Ciani, N. (1996). Clinical predictors of somatic and psychological symptoms of depression in Alzheimer's disease. International Journal of Geriatric Psychiatry, 11, 23–27.Google Scholar
Vuilleumier, P. (2004). Anosognosia: The neurology of beliefs and uncertainties. Cortex, 40, 9–17.Google Scholar