This little-known condition, anosognosia, can be the consequence of Alzheimer’s disease and other brain disorders. A patient can be clinically unaware that they are compromised by illness.
The term, pronounced a-no-son-yo-see-a, was first coined in more than 100 years ago when neurologist Joseph Babinski noticed that some of his patients seemed to be unaware of how their mental and physical faculties had changed after surviving a stroke.
Anosognosia is a condition where an individual, though medically diagnosed with an illness, is still unable to recognize the health condition from which they suffer. In other words, people with an illness they don’t know they have.
Although somewhat common, this condition is little-known and can be the consequence of Alzheimer’s disease and other brain disorders. It leaves people unaware that they are compromised by illness and that anything is wrong.
Imagine someone who after a stroke survives but is paralyzed on one side of his body but is convinced that he can still walk without assistance. This situation should not be considered a simple denial, but a lack of insight and awareness while everyone else around them is aware they’re not the same, and they are not.”
Sometimes anosognosia is selective: An aging parent may realize they have a problem with one kind of activity but are oblivious to difficulties in other areas. In some cases, the lack of self-awareness is more extensive and generalized.
According to some estimates, about 40-45% of patients with Alzheimer’s disease have symptoms of anosognosia, mostly at the early stages of the disease. However, as the dementia advances the symptoms also progress. Trying to make someone with this problem understand that they have changed and need to accept new limits is very often difficult. Reasoning and evidence make little difference to these patients.
Studies suggest that the lack of awareness may be linked to the deterioration of a particular area of the brain called the frontal lobes, especially on the right side, which play a role in problem-solving, planning, and understanding the context and meaning of experiences.
If a loved one has anosognosia, sometimes it's best not to try to convince them that they're ill. Instead, engage them in talks about their goals, or activities that may interest them. This might encourage them to meet with a mental health professional, even if they don't think they need it for their health and well-being
If someone you love has anosognosia, it is ok to feel sad or frustrated. Here are a few useful tips for supporting our loved ones with this condition.
• The condition is not a choice. It is not a denial of symptoms on purpose, but another symptom of the condition per se.
• Be patient and compassionate while you are trying to help them gain some insight into their current situation and how they can improve.
• Avoid any confrontation and argument about it if you witness incidents secondary to the condition.
Domenico Praticò, MD, holds the position of the Scott Richards North Star Charitable Foundation Chair for Alzheimer’s Research and serves as a Professor and the Founding Director at the Alzheimer’s Center at Temple, as well as a Professor of Neural Sciences at Lewis Katz School of Medicine at Temple University.
For more information on the research conducted by Dr. Domenico Pratico, please visit this link.
Connect with Dr. Domenico Pratico through LinkedIn, Facebook, Twitter, Medium.
Stay updated with the work happening at Dr. Domenico Pratico's lab by visiting the Pratico Lab website.
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