Anosognosia Is Associated With Greater Caregiver Burden and Poorer Executive Function in Huntington Disease

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Abstract

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.

Original languageEnglish
Number of pages7
JournalJournal of Geriatric Psychiatry and Neurology
DOIs
Publication statusE-pub ahead of print - 18 Jun 2019

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Agnosia
Huntington Disease
Executive Function
Caregivers
Interviews
Equipment and Supplies
Dementia
Demography

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@article{877377472c1c4375bda08bbb9f34dd64,
title = "Anosognosia Is Associated With Greater Caregiver Burden and Poorer Executive Function in Huntington Disease",
abstract = "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.",
keywords = "anosognosia, caregiver burden, executive functioning, Huntington disease, insight, movement disorder",
author = "P. Wibawa and R. Zombor and M. Dragovic and B. Hayhow and J. Lee and Panegyres, {P. K.} and D. Rock and Starkstein, {S. E.}",
year = "2019",
month = "6",
day = "18",
doi = "10.1177/0891988719856697",
language = "English",
journal = "Journal of Geriatric Psychiatry and Neurology",
issn = "0891-9887",
publisher = "SAGE Publications Ltd",

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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 - 2019/6/18

Y1 - 2019/6/18

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.

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