Department of Psychiatry, Faculty of Medicine, University of Leipzig, D-04103 Leipzig, Germany.
J Int Neuropsychol Soc. 2010 May;16(3):463-73. doi: 10.1017/S1355617710000056. Epub 2010 Mar 1.
Impaired insight for deficits (anosognosia) is common in Alzheimer's disease (AD). However, it has not yet been determined clearly (a) whether different methods for assessing insight are comparable, and (b) whether anosognosia affects different domains to different degrees (domain-specificity). Impaired insight was investigated in 32 patients with AD, who were each accompanied by a caregiver. Anosognosia was assessed by a global clinical rating, questionnaire discrepancies (patient vs. caregiver) covering different domains, and performance discrepancies (self-assessment vs. performance) based on four neuropsychological tests which were compared with those of a healthy control sample. The results of clinical rating and questionnaire discrepancies were closely correlated, but performance discrepancies showed no association with the other methods. Anosognosia was present in the majority of the sample, and occurred across domains. The domains corresponding to core deficits in AD (recent memory, activities of daily living) appeared especially prone to anosognosia. However, results do not suggest that anosognosia itself is domain-specific. Rather, it appears that insight may be invariant, while differences in patient-caregiver discrepancies arise largely from different degrees of deficit across domains.
在阿尔茨海默病（AD）中，对缺陷的洞察力受损（认知不能）很常见。然而，目前尚未明确（a）评估洞察力的不同方法是否具有可比性，以及（b）认知不能是否会以不同程度影响不同的领域（领域特异性）。研究了 32 名 AD 患者及其每位照顾者的洞察力受损情况。通过整体临床评分、涵盖不同领域的问卷差异（患者与照顾者）以及基于四项神经心理学测试的自我评估与表现差异（自我评估与表现）来评估认知不能，并与健康对照组进行了比较。临床评分和问卷差异的结果密切相关，但表现差异与其他方法没有关联。认知不能在大多数样本中存在，并发生在各个领域。与 AD 的核心缺陷相对应的领域（近期记忆、日常生活活动）尤其容易出现认知不能。然而，结果并未表明认知不能本身具有领域特异性。相反，洞察力似乎是不变的，而患者与照顾者之间的差异主要源于不同领域的缺陷程度不同。
