Imagine you’re trying to diagnose a car problem, but you can only rely on what the driver tells you. You need more information! That’s exactly what scientists are doing with Alzheimer’s disease. They want to understand the different types of cognitive complaints and awareness experienced by individuals across the disease spectrum. By using self-report and informant-report measures, they investigated complaints related to memory, language, visuospatial abilities, and executive functions. Interestingly, participants with Alzheimer’s showed a lack of awareness (anosognosia) particularly in the executive domain. The study found that informants were more accurate in reporting memory and language complaints compared to the individuals themselves. This research suggests that non-memory complaints could still be linked to Alzheimer’s disease, highlighting the importance of studying a wider range of cognitive functions. So, if you want to dive deeper into this fascinating study on cognitive complaints and awareness in Alzheimer’s, check out the full article!

Background: Characterizing self- and informant-reported cognitive complaints, as well as awareness of cognitive decline (ACD), is useful for an early diagnosis of Alzheimer’s disease (AD). However, complaints and ACD related to cognitive functions other than memory are poorly studied. Furthermore, it remains unclear which source of information is the most useful to distinguish various groups on the AD spectrum.
Methods: Self- and informant-reported complaints were measured with the Everyday Cognition questionnaire (ECog-Subject and ECog-StudyPartner) in four domains (memory, language, visuospatial, and executive). ACD was measured as the subject-informant discrepancy in the four ECog scores. We compared the ECog and ACD scores across cognitive domains between four groups: 71 amyloid-positive individuals with amnestic AD, 191 amnestic mild cognitive impairment (MCI) or 118 cognitively normal (CN), and 211 amyloid-negative CN controls, selected from the ADNI database. Receiver operating characteristic curves analysis was performed to evaluate the accuracy of the ECog and ACD scores in discriminating clinical groups.
Results: Self- and informant-reported complaints were generally distributed as follows: memory, language, executive, and visuospatial (from the most severe to the least severe). Both groups of CN participants presented on average more memory and language complaints than their informant. MCI participants showed good agreement with their informants. AD participants presented anosognosia in all domains, but especially for the executive domain. The 4 ECog-StudyPartner sub-scores allowed excellent discrimination between groups in almost all classifications, and performed significantly better than the other two classifiers considered. The ACD was excellent in distinguishing the participants with AD from the two groups of CN participants. The ECog-Subject was the least accurate in discriminating groups in four of the six classifications performed.
Conclusion: In research, the study of complaint and anosognosia should not be reduced solely to the memory domain. In clinical practice, non-amnestic complaints could also be linked to Alzheimer’s disease. The presence of an informant also seems necessary given its accuracy as a source of information.

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