The association between anosognosia and neuropsychiatric symptoms in neurodegenerative dementias: a narrative review
- PMID: 41079349
- PMCID: PMC12511066
- DOI: 10.3389/fneur.2025.1649627
The association between anosognosia and neuropsychiatric symptoms in neurodegenerative dementias: a narrative review
Abstract
Anosognosia, or unawareness of disease, is a common clinical feature in neurodegenerative dementias. Frequently reported as an early symptom, its presence has been associated with faster dementia progression and greater cognitive impairment. Similarly, neuropsychiatric symptoms (NPS) encompass non-cognitive behavioral and psychiatric disturbances that commonly affect individuals with dementia. Both aosognosia and NPS are clinically relevant in neurodegenerative diseases due to their significant implications in disease management and caregiver burden. In this narrative review, we examined studies investigating the direct relationship between anosognosia and NPS across different neurodegenerative dementias, including Alzheimer's Disease (AD), Frontotemporal Dementia (FTD) and α-synucleinopathies, such as Parkinson's Disease (PD) and Dementia with Lewy Bodies (DLB). A total of 46 studies were identified, the majority of which focused on AD. Despite considerable heterogeneity in participant selection, assessed domains, and measures of anosognosia and NPS investigated, consistent association emerged between anosognosia and global NPS scores as well as individual symptoms. Across studies, the most common finding was a negative association between anosognosia and depression and a positive association between anosognosia and apathy. Possible underlying mechanisms and shared neuroanatomical substrates of these findings are discussed. The review provides a deepened insight into key symptoms with critical implications for dementia research, clinical management, and caregiving strategies.
Keywords: Alzheimer’s disease; anosognosia; dementia; frontotemporal dementia; neuropsychiatric symptoms; unawareness.
Copyright © 2025 Gallingani, Tondelli, Vannini and Zamboni.
Conflict of interest statement
GZ has received speaker honoraria from Ely Lilly. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
Figures
References
-
- Kaszniak A, Edmonds E. Anosognosia and Alzheimer’s disease: behavioral studies In: The study of anosognosia, Ed. Prigatano, George P. (New York, Oxford: Oxford University Press) (2010) 189–228.
-
- Castrillo Sanz A, Andrés Calvo M, Repiso Gento I, Izquierdo Delgado E, Gutierrez Ríos R, Rodríguez Herrero R, et al. Anosognosia in Alzheimer disease: prevalence, associated factors, and influence on disease progression. Neurologia. (2016) 31:296–304. doi: 10.1016/j.nrl.2015.03.006, PMID: - DOI - PubMed
Publication types
LinkOut - more resources
Full Text Sources
