Is Anosognosia in Alzheimer disease also observed for behavioural and personality changes?

Anosognosia is a frequent manifestation in Alzheimer disease (AD) but its extent is not yet clearly established. While anosognosia for memory deficit has been widely reported, no study has simultaneously explored anosognosia for personality and behaviour changes.
We have tackled this question with 20 AD patients and 20 matched elderly subjects (ES). Participants (AD and ES) assessed their personality and their reactions in social situation both in current (S1) and past (S1_bef) time period. Assessment of these characteristics was also performed by relatives of the participants (R2 and R2_bef). Mann-Whitney test (p<0.05) were performed between discrepancy scores (calculated by comparing answers of subjects and relatives) obtained for AD and ES. A specific measure of anosognosia was also calculated by comparing S1 and R2.
Statistical analyses demonstrated (1) that relatives of AD patients report more personality and behavioural changes across time (S1-S1_bef) than relatives of ES (R2–R2_bef); (2) that self-reported changes were not significantly different between AD patients and ES; (3) that anosognosia (S1-R2) was observed in AD patients for personality changes only.
Results obtained support the hypothesis that anosognosia does not affect all domain in AD. Indeed, even if AD patients are no more able to assess their current personality, they perceive adequately their current reactions in social situations.