Influence of anosognosia on treatment outcome among dementia patients

Abstract

This study was a preliminary investigation of the effects of a Memory and Coping Program among mild to moderate dementia patients. A total of 24 elderly participants were randomly assigned to treatment and waiting-list control conditions. A pre-test, post-test design was used, with group comparisons of change scores on objective cognitive tests and subjective ratings of mood and memory. While encouraging trends emerged suggesting improvement among those who received treatment, group differences did not reach statistical significance. However, when outcomes were compared by treatment subgroups with and without anosognosia, significant differences emerged. Participants with insight made significantly greater gains in perceived memory functioning that those without insight. In contrast, informants perceived greater gains among treatment subjects relative to controls independent of insight status. The need for additional research to further delineate the influences of anosognia, baseline cognition, and affective status, and other potential intervention outcome modifiers is discussed, with attention to instrumentation and methodological considerations.