Anosognosia: The Complicated Condition That Affects Most Dementia Patients
- Neuro-Behavioral Clinical Research
- Jul 7
- 3 min read
Coping with dementia presents significant hurdles for both individuals diagnosed and those who care for them.
One of the reasons it can be so difficult to navigate is due to dementia and Alzheimer's disease patients' inability to acknowledge or accept their cognitive deficits, a condition called anosognosia.
What is anosognosia?
Anosognosia means "without knowledge of disease"; it's a neurological condition where the brain can't recognize its cognitive or psychiatric illness.
Anosognosia is common in a number of neurological diseases and affects approximately 95% of early-onset dementia patients and 98% of late-onset dementia patients, according to a 2021 Frontiers in Psychiatry article.Â
People with anosognosia are much more likely to downplay their symptoms and resist treatment. The combination of dementia and anosognosia symptoms might look like:
A woman insisting she can drive after her license was taken away, then getting upset when her husband won't hand over the keysÂ
A mother struggling to cook elaborate recipes for holidays that she has made every year (mixing up ingredients, missing steps, etc.) but refusing help and getting frustrated when family members offer it
A husband getting lost on his usual neighborhood walk but insists he's fine to take the same walk again the next day because he "knows the route by heart"
Caring for someone with anosognosia
A person with anosognosia may forget their dementia diagnosis and the impact it has on their daily life. They may also have fluctuating levels of awareness around their condition and the tasks they need help with.Â
It's important to help your loved one experience independence when it's safe for them to do so. In other words, if they're able to do something without harming themselves, let them have that moment of self-sufficiency.Â
You can also suggest taking on activities (like cooking, cleaning, and errands) together, so they don't feel as though you're taking over or stepping on their toes. After all, how would you feel if people tried to do things for you that you've always been (and still are, in your mind) capable of doing?Â
When they become frustrated, sad, angry, or overwhelmed, acknowledging their emotions (rather than using logic) can help defuse the situation. And above all, don't take things personally, they aren't in control of their cognitive function, and their brain struggles to make connections the way it once did.
Anosognosia can look a lot like stubbornness and/or denial, but know it's a real condition that can make dementia symptoms that much more overwhelming. The 2021 Frontiers in Psychiatry article notes that anosognosia has been shown to increase over time with dementia progression and is more prevalent in dementia and Alzheimer's disease variants that impact the frontal lobe.
Medication in some individuals can be beneficial and may help improve self-awareness and possibly reduce their inability to accept their diagnosis, resulting in being more accepting of assistance/support. Most times, the best results come from a more roundabout approach— showing the individual benefits of having some support with regard to other aspects of their life, such as continuing to live as independently as possible.
As with most aspects of dementia care, remain calm and compassionate. Trying different strategies and routines are the most important things to do. There are certainly times when it is counterproductive to attempt to convince a loved one that they are suffering from dementia. Unfortunately, it sometimes takes a crisis to get your loved one the help and support they need.Â
As care providers, we continue to educate and care for ourselves with new approaches and ways to support our loved ones challenged with this condition. The measures for preventing the development or progression of anosognosia are similar to dementia-preventing tips: Maintain a healthy body composition, eat a well-balanced diet, and engage in physical activity regularly.Â
The Takeaway
Up to 98% of dementia patients have a concurrent neurological condition called anosognosia, which makes it difficult for them to remember or be fully aware of their illness.
For dementia patients, this can be overwhelming and scary; for their caretakers, it can present additional challenges. If you think you or someone you love has anosognosia, be sure to discuss the best course of action with your doctor.
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