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Anosognosia and avoidant coping do not impact work in early Huntington's disease
Kasper Frederik van der Zwaan1, Raymund Ac Roos1, Susanne T de Bot1
1Department of Neurology, LUMC, Leiden, The Netherlands.
Journal of Huntington'S Disease
|June 11, 2025
Summary
In Huntington's disease (HD), anosognosia (impaired self-awareness) and avoidant coping strategies are linked to cognitive decline but do not directly impact work capacity. Recognizing these factors is crucial in early HD stages.
Area of Science:
- Neuroscience
- Psychology
- Occupational Health
Background:
- Work is vital for financial stability and well-being.
- Huntington's disease (HD) significantly impacts work capacity.
- Anosognosia and avoidant coping are common in HD but their relation to work outcomes is unexplored.
Purpose of the Study:
- To investigate the relationships between anosognosia, coping styles, and work capacity in individuals with pre-motor and motor manifest HD.
- To explore the impact of cognitive and motor functioning on these relationships.
Main Methods:
- Analysis of the HD-Work dataset including 117 participants with pre-motor and motor manifest HD.
- Assessment of motor and cognitive functioning, coping styles (Utrechtse Coping Lijst), work capacity (Total Functional Capacity scale), and anosognosia (expert rating, participant-proxy, cognitive-performance discrepancies).
Main Results:
- Anosognosia strongly correlated with cognitive decline and frontal behaviors.
- Avoidant coping was less prevalent, associated with frontal behaviors, but not directly with work capacity.
- A positive association was found between avoidant coping and anosognosia; passive coping was most common.
Conclusions:
- Cognitive decline is the primary predictor of anosognosia in HD.
- Avoidant coping may be misattributed to anosognosia, highlighting the need to recognize these strategies in early HD.
- While anosognosia and avoidant coping are linked to cognitive decline, they do not directly affect work capacity in HD.
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