title: Anosognosia in people with cognitive impairment: association with cognitive deficits and behavioral disturbances.
abstract: OBJECTIVE
  To investigate, in a group of subjects at an early stage of cognitive impairment, the relationship between anosognosia and both cognitive and behavioral symptoms by exploring the various domains of insight.
  
  
  METHODS
  One hundred and eight subjects affected by cognitive impairment were consecutively enrolled. The level of awareness was evaluated by means of the Clinical Insight Rating Scale (CIRS). Psychiatric symptoms were evaluated using the Italian version of the Neuropsychiatric Inventory (NPI), whereas memory (memory index, MI) and executive (executive index, EI) functions were explored using a battery of neuropsychological tests and qualified by means of a single composite cognitive index score for each function.
  
  
  RESULTS
  A significant positive correlation between the total NPI score and global anosognosia score was found. Furthermore, both the MI and EI scores were lower in subjects with anosognosia than in those without anosognosia (p < 0.001 and p < 0.007, respectively). When the single domains of the CIRS were considered, anosognosia of reason of visit correlated with the EI score (r = -0.327, p = 0.01) and night-time behavioral disturbances (r = 0.225; p = 0.021); anosognosia of cognitive deficit correlated with depression (r = -0.193; p = 0.049) and the MI score (r = -0.201; p = 0.040); anosognosia of functional deficit correlated with the MI score (r = -0.257; p = 0.008), delusions (r = 0.232; p = 0.015) and aberrant motor behavior (r = 0.289; p = 0.003); anosognosia of disease progression correlated with the MI score (r = -0.236; p = 0.015), agitation (r = 0.247; p = 0.011), aberrant motor behavior (r = 0.351; p = 0.001) and night-time behavioral disturbances (r = 0.216; p = 0.027).
  
  
  CONCLUSIONS
  Our study suggests that, in the early stage of cognitive impairment, anosognosia is associated with both cognitive deficits and behavioral disorders according to the specific functional anatomy of the symptoms.
authors: NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
authors: Antonella
authors: A
authors: De Carolis
authors: NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
authors: Virginia
authors: V
authors: Cipollini
authors: NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
authors: Valentina
authors: V
authors: Corigliano
authors: NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
authors: Anna
authors: A
authors: Comparelli
authors: NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
authors: Micaela
authors: M
authors: Sepe-Monti
authors: NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
authors: Francesco
authors: F
authors: Orzi
authors: NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
authors: Stefano
authors: S
authors: Ferracuti
authors: NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
authors: Franco
authors: F
authors: Giubilei
keywords: Anosognosia; Behavioral symptoms; Cognitive impairment; Dementia