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Journal of Geriatric Psychiatry and Neurology
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Impaired Insight in Alzheimer's Disease

Carlos A. Mangone, MD

Center for Alzheimer Disease at Humana Hospital-Michael Reese, University of Illinois, Chicago, IL

Daniel B. Hier, MD

Department of Neurology, University of Illinois, Chicago, IL

Philip B. Gorelick, MD, MPH

Center for Alzheimer Disease at Humana Hospital-Michael Reese, University of Illinois, Chicago, IL, Department of Neurology, University of Illinois, Chicago, IL

Ronald J. Ganellen, PhD

Center for Alzheimer Disease at Humana Hospital-Michael Reese, University of Illinois, Chicago, IL, School of Public Health University of Illinois, Chicago, IL

Patricia Langenberg, PhD

School of Public Health University of Illinois, Chicago, IL

Regina Boarman, MSW

Center for Alzheimer Disease at Humana Hospital-Michael Reese, University of Illinois, Chicago, IL

Winifred C. Dollear, BSN, MPH

Center for Alzheimer Disease at Humana Hospital-Michael Reese, University of Illinois, Chicago, IL

We studied insight into illness in 41 patients with probable Alzheimer's disease. An impaired insight score was developed by measuring discrepancies between patient report and caregiver report on standard instruments of activities of daily living. Insight was more impaired in subjects with greater dementia severity and subjects with paranoid delusions. In a multivariate analysis, the best neuropsychological predictors of impaired insight were the Continuous Performance Test and the Visual Reproduction Test. We speculate that the impaired insight of Alzheimer's disease has two components: confabulation reflecting prefrontal dysfunction and anosognosia reflecting right-hemisphere dysfunction. (J Geriatr Psychiatry Neurol 1991;4:189-193).

Journal of Geriatric Psychiatry and Neurology, Vol. 4, No. 4, 189-193 (1991)
DOI: 10.1177/089198879100400402
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