title: Cognition and psychopathology in nonagenarians and centenarians living in geriatric nursing homes in Switzerland: a focus on anosognosia.
abstract: BACKGROUND
  The number of nonagenarians and centenarians is rising dramatically, and many of them live in nursing homes. Very little is known about psychiatric symptoms and cognitive abilities other than memory in this population. This exploratory study focuses on anosognosia and its relationship with common psychiatric and cognitive symptoms.
  
  
  METHODS
  Fifty-eight subjects aged 90 years or older were recruited from geriatric nursing homes and divided into five groups according to Mini-Mental State Examination scores. Assessment included the five-word test, executive clock-drawing task, lexical and categorical fluencies, Anosognosia Questionnaire-Dementia, Neuropsychiatric Inventory, and Charlson Comorbidity Index.
  
  
  RESULTS
  Subjects had moderate cognitive impairment, with mean ± SD Mini-Mental State Examination being 15.41 ± 7.04. Anosognosia increased with cognitive impairment and was associated with all cognitive domains, as well as with apathy and agitation. Subjects with mild global cognitive decline seemed less anosognosic than subjects with the least or no impairment. Neither anosognosia nor psychopathological features were related to physical conditions.
  
  
  CONCLUSIONS
  Anosognosia in oldest-old nursing home residents was mostly mild. It was associated with both cognitive and psychopathological changes, but whether anosognosia is causal to the observed psychopathological features requires further investigation.
authors: Service of Old Age Psychiatry, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV), Prilly-Lausanne, Switzerland.
authors: Jean-Frédéric
authors: JF
authors: Mall
authors: Leila
authors: L
authors: Chouiter
authors: Jean-Philippe
authors: JP
authors: Antonietti
authors: Karsten
authors: K
authors: Ebbing
authors: Armin
authors: A
authors: von Gunten
mesh_terms: D000369:Aged, 80 and over; D000377:Agnosia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology
keywords: anosognosia; apathy; cognition; depression; oldest old; psychopathology