TY - JOUR
T1 - Anosognosia Is Associated With Greater Caregiver Burden and Poorer Executive Function in Huntington Disease
AU - Wibawa, P.
AU - Zombor, R.
AU - Dragovic, M.
AU - Hayhow, B.
AU - Lee, J.
AU - Panegyres, P. K.
AU - Rock, D.
AU - Starkstein, S. E.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Anosognosia, or unawareness of one’s deficits, is estimated to occur in 25% to 50% of Huntington disease (HD). The relationship between anosognosia and increased caregiver burden found in other dementias has not been determined in HD. Methods: Patient–caregiver dyads presenting to a statewide HD clinic were assessed using the Anosognosia Scale and grouped into “anosognosia” and “no anosognosia.” Caregiver burden, measured by Zarit Burden Interview (ZBI) and Caregiver Burden Inventory (CBI), demographic data, and Unified Huntington’s Disease Rating Scale, including Mini-Mental State Examination, Stroop, Trail Making, Verbal Fluency, and Symbol Digit Modalities Tests, were compared between groups. Results: Of the 38 patients recruited, 10 (26.3%) met criteria for anosognosia. Patients with anosognosia elicited higher caregiver burden ratings on both the ZBI (mean difference 16.4 [12.1], P <.001) and CBI (16.7 [15.0], P <.005) while also demonstrating poorer executive function. Except for CAG burden score, between-group characteristics did not differ significantly. Stroop Interference predicted both anosognosia and caregiver burden. Conclusions: In HD, anosognosia is associated with greater caregiver burden and executive deficits. Its occurrence should prompt further patient assessment and increased caregiver support.
AB - Background: Anosognosia, or unawareness of one’s deficits, is estimated to occur in 25% to 50% of Huntington disease (HD). The relationship between anosognosia and increased caregiver burden found in other dementias has not been determined in HD. Methods: Patient–caregiver dyads presenting to a statewide HD clinic were assessed using the Anosognosia Scale and grouped into “anosognosia” and “no anosognosia.” Caregiver burden, measured by Zarit Burden Interview (ZBI) and Caregiver Burden Inventory (CBI), demographic data, and Unified Huntington’s Disease Rating Scale, including Mini-Mental State Examination, Stroop, Trail Making, Verbal Fluency, and Symbol Digit Modalities Tests, were compared between groups. Results: Of the 38 patients recruited, 10 (26.3%) met criteria for anosognosia. Patients with anosognosia elicited higher caregiver burden ratings on both the ZBI (mean difference 16.4 [12.1], P <.001) and CBI (16.7 [15.0], P <.005) while also demonstrating poorer executive function. Except for CAG burden score, between-group characteristics did not differ significantly. Stroop Interference predicted both anosognosia and caregiver burden. Conclusions: In HD, anosognosia is associated with greater caregiver burden and executive deficits. Its occurrence should prompt further patient assessment and increased caregiver support.
KW - anosognosia
KW - caregiver burden
KW - executive functioning
KW - Huntington disease
KW - insight
KW - movement disorder
UR - http://www.scopus.com/inward/record.url?scp=85068003988&partnerID=8YFLogxK
U2 - 10.1177/0891988719856697
DO - 10.1177/0891988719856697
M3 - Article
C2 - 31213121
AN - SCOPUS:85068003988
VL - 33
SP - 52
EP - 58
JO - Journal of Geriatric Psychiatry and Neurology
JF - Journal of Geriatric Psychiatry and Neurology
SN - 0891-9887
IS - 1
ER -