Dementia and awareness

Haruo Hanyu

Department of Geriatric Medicine, Tokyo Medical University

Patients with dementia frequently demonstrate impaired awareness of their cognitive and functional difficulties. We examined several aspects of unawareness of memory deficits in Alzheimer's disease（AD）and other dementias, including the level and frequency in various dementing disorders, progression over time, and neuroanatomical correlates. Impaired awareness was found in two-thirds of patients with mild AD and even in one-third of patients with mild cognitive impairment. However, other dementias, in particular dementia with Lewy bodies, had less severe and less frequent unawareness of memory deficits than AD. A longitudinal study showed that impaired awareness progressed with cognitive decline. Functional damage to the inferior, medial and orbital frontal lobe as well as the anterior cingulate gyri may be associated with the lack of awareness on a SPECT study.

Address correspondence to Dr. Haruo Hanyu, Department of Geriatric Medicine, Tokyo Medical University (6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023)