Article Text

Download PDFPDF

Self awareness and personality change in dementia
Free
  1. K P Rankin,
  2. E Baldwin,
  3. C Pace-Savitsky,
  4. J H Kramer,
  5. B L Miller
  1. University of California San Francisco Memory and Aging Center, 350 Parnassus Avenue, Suite 706, San Francisco, CA 94143-1207, USA
  1. Correspondence to:
 Dr K P Rankin
 UCSF Memory and Aging Center, 350 Parnassus Avenue, Suite 706, San Francisco, CA 94143-1207, USA; krankinmemory.ucsf.edu

Abstract

Background: Loss of insight is a core diagnostic criterion for frontotemporal dementia (FTD), whereas failure to recognise cognitive deficits and unawareness of disease (anosognosia) are well established findings in Alzheimer’s disease (AD). However, self awareness of personality has not been quantified in these patient groups.

Methods: Twenty two patients (12 with frontal variant FTD; 10 with early AD) and 11 older adult normal controls completed self report questionnaires (the Interpersonal Adjectives Scales) describing their current personality. First degree relative informants completed two questionnaires, one describing the subject’s current personality, the other retrospectively describing the subject’s personality before disease onset. Differences between subject and informant reports of current personality were used to measure the accuracy of self awareness.

Results: Discriminant function analysis showed significant differences in self awareness among the three groups, with those in the FTD group showing the greatest magnitude of error in the largest number of personality dimensions (dominance, submissiveness, cold heartedness, introversion, and ingenuousness). Despite personality changes over time, patients with AD showed accurate self awareness in all personality dimensions except submissiveness and extraversion. Normal controls showed a pattern of underestimating positive qualities, whereas patients with FTD exaggerated positive qualities and minimised negative qualities. For the personality facets showing impaired insight, the self reports of patients with FTD and AD most closely matched their premorbid personalities, suggesting a failure to update their self image after disease onset.

Conclusions: This study operationalises research criteria for loss of insight in FTD.

  • AD, Alzheimer’s disease
  • CDR, Clinical Dementia Rating scale
  • FTD, frontotemporal dementia
  • IAS, Interpersonal Adjectives Scale
  • InsNow, insight into current personality
  • VL, vector length

Statistics from Altmetric.com

Footnotes

  • Competing interests: none declared

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.