title: Self-awareness in Mild Cognitive Impairment: Quantitative evidence from systematic review and meta-analysis.
abstract: Here we quantitatively summarized evidence of impaired awareness in Mild Cognitive Impairment (MCI) and meta-analytically explored the relationship between Subjective Cognitive Complaints (SCC) and actual cognitive impairment. Twenty-three studies were included, 14 comparing awareness measures in MCI and healthy elderly subjects, and 16 also exploring the neuropsychological underpinnings of impaired awareness. Moderator analyses were conducted to determine whether self-awareness varied according to patient group, the particular state in relation to which insight was assessed, or the approach to measuring awareness. The meta-analysis shows that MCI patients have knowledge of their neuropsychological deficits and that level of awareness varies according to cognitive status, language and memory abilities. The assessment technique employed impacted on the insight phenomena. Specifically, MCI patients seem particularly accurate in evaluating the current state of their performance during an ongoing task and this could be essential in regulating their behavior so that compensative strategies are practiced and greater cognitive independence is achieved. Thus, assessment technique and cognitive status are crucial factors that influence level of awareness and should be taken into consideration in awareness evaluation and rehabilitation.
authors.affiliation: Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, IRCSS Santa Lucia Foundation, Rome, Italy. Electronic address: federica.piras@hsantalucia.it.
authors.forename: Federica
authors.initials: F
authors.lastname: Piras
authors.affiliation: Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, IRCSS Santa Lucia Foundation, Rome, Italy; Centro Studi e Ricerche Enrico Fermi, Compendio del Viminale, Rome, Italy. Electronic address: f.piras@hsantalucia.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Piras
authors.affiliation: Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, IRCSS Santa Lucia Foundation, Rome, Italy. Electronic address: md.orfei@hsantalucia.it.
authors.forename: Maria Donata
authors.initials: MD
authors.lastname: Orfei
authors.affiliation: Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, IRCSS Santa Lucia Foundation, Rome, Italy; Department of Medicine of Systems, Tor Vergata University of Rome, Rome, Italy. Electronic address: c.caltagirone@hsantalucia.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Caltagirone
authors.affiliation: Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, IRCSS Santa Lucia Foundation, Rome, Italy; Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA. Electronic address: g.spalletta@hsantalucia.it.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Spalletta
mesh_terms: D001364:Awareness / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008568:Memory / Q000502:physiology*; D008569:Memory Disorders / Q000503:physiopathology / Q000523:psychology*; D009483:Neuropsychological Tests; D010465:Perception / Q000502:physiology
keywords: Assessment technique; Awareness; Insight; Language; Memory; Mild Cognitive Impairment