Public Health

Area of Science:

• Neuroscience
• Gerontology
• Public Health

Background:

• Anosognosia, the lack of awareness of one's condition, impacts 20-40% of individuals with major neurocognitive disorders (MNCD), including Alzheimer's disease.
• This unawareness stems from memory impairments and prefrontal brain dysfunction, causing individuals to overestimate abilities and resist care.
• Resistance to care leads to care plan failure, caregiver burden, and crises like hospitalization or institutionalization.

Purpose of the Study:

• To highlight the critical role of multidimensional assessments in identifying deficits related to anosognosia in MNCD.
• To emphasize the need for standardized evaluation tools sensitive to anosognosia's impact on risk awareness and decision-making.
• To propose innovative, person-centered care strategies integrating technology and intersectoral collaboration for improved management of Alzheimer's disease.

Main Methods:

• Multidimensional assessments including neuropsychological testing, caregiver reports, neuroimaging (MRI, PET), and biomarkers.
• Analysis of discourse patterns in individuals with MNCD to identify overestimation of abilities.
• Review of existing care frameworks and policies, such as Quebec's Alzheimer Plan.

Main Results:

• Anosognosia impairs risk awareness and decision-making due to prefrontal and limbic brain dysfunction.
• Alzheimer's disease is characterized by impaired adaptability, not just memory loss.
• Discourse analysis reveals overestimation of abilities, leading to safety risks and care refusal.

Conclusions:

• Standardized evaluation tools are urgently needed to address anosognosia in MNCD.
• Care strategies should prioritize adaptability and leverage technology for dynamic risk management.
• Intersectoral collaboration is crucial for bridging research and real-world care implementation, enhancing assessment and care for Alzheimer's patients.