Burden Associated with the Presence of Anosognosia in Alzheimer's Disease

Objectives: Anosognosia is the lack of deficit awareness, and it is a common symptom in patients with Alzheimer's disease (AD). The objective of this study was to assess the relationship between anosognosia and caregiver burden.

Methods: This was a cross-sectional, analytical study of patients who were diagnosed with AD and their caregivers. Anosognosia was evaluated using the Experimenter Rating Scale, and caregiver burden was evaluated using the Burden Interview (BI). Using the BI's comprehensive scoring and each of its five factors as dependent variables, we adjusted six linear regression models to determine the effect of anosognosia on caregiver burden.

Results: The sample consisted of 124 patients and 124 caregivers. The mean patient age was 78.9 years (SD = 6.9); the mean caregiver age was 59.7 years (SD = 13.6), and 66.6% of the caregivers were women. The prevalence of anosognosia was 24.2% (95% confidence interval = 16.7-33.3). The degree of caregiver burden was associated with the degree of anosognosia (r(2)  = 0.426; standardised beta [βs] = 0.346; p < 0.001), which explained 14.7% of the variance. For the BI factors, the Experimenter Rating Scale was associated with physical and social burden (r(2)  = 0.452; βs = 0.378; p < 0.001), relationship of dependence (r(2)  = 0.301; βs = 0.203; p = 0.010) and emotional stress (r(2)  = 0.212; βs = 0.227; p = 0.014).

Conclusions: The presence of anosognosia in patients with AD is an independent factor that increases caregiver burden by increasing physical wear, social isolation, dependence and tension related to patient care.