Heterogeneity of anosognosia in Alzheimer’s disease according to the object of awareness.

Anosognosia or unawareness of neuropsychological deficits, other symptoms, or the illness itself is frequent in Alzheimer's disease (AD). The aim of this study was to explore the multidimensionality of awareness in AD, comparing directly the awareness of patients in relation to several different objects: executive functions, depression, apathy, disinhibition, and overall condition. Awareness was determined by discrepancy between patient- and informant-report. The results showed that the level of awareness differs according to the object studied, with awareness for overall condition and executive functions being more impaired and relatively more preservation of awareness for disinhibition and apathy. Correlational analysis suggested that awareness for executive function impairment, apathy, and condition correlate strongly, while awareness of depression appears to be an independent construct. These findings have several clinical implications, highlighting the importance of a more thorough evaluation of the patients' awareness.