Beyond Denial: Anosognosia and Alzheimer's Disease

By Lynn Marie Witt, MSOT

2 min read

"The doctors do not know what they are talking about. I don't have Alzheimer's disease!" This probably sounds familiar to some of you reading this right now.

A lot of our loved ones with Alzheimer's disease might say this often. It has to be that our loved ones are in denial. But what if I told you that it might be more than denial. More than denial?

What is anosognosia?

Anosognosia is a person's inaccurate assessment of their limitations in daily activities. Anosognosia is pronounced uh-no-sog-NOH-zee-uh.¹

In people with Alzheimer's, anosognosia can show up as denial or lack of awareness of impairments in activities of daily living (ADLs) or about neuropsychological deficits.¹

One study reported that anosognosia is very common in people with Alzheimer's disease. Researchers estimate that more than 8 out of 10 people with Alzheimer's have some form of anosognosia.²

Why does anosognosia happen?

Experts in the field of Alzheimer's believe anosognosia occurs when the frontal lobe of a person's brain deteriorates or becomes damaged. The frontal lobe is in charge of our ability to:¹

Think abstractly
Perceive
Problem-solve
Socialize

Damage to the frontal lobe will cause a person to have problems with the above-mentioned skills.

Is it denial or anosognosia?

The lack of awareness with anosognosia is very different from the initial shock and denial a person may feel after their diagnosis. The brain changes that come with Alzheimer's disease and other forms of dementia may leave the person believing they are perfectly healthy.¹

A person with anosognosia can experience selective or complete lack of awareness. Your loved one's physician can run very specific tests to help diagnose the condition.

There are 5 signs your loved one has dementia with anosognosia:³

Unable to maintain normal everyday tasks and/or personal hygiene.
Showing less inhibition and increased spontaneity in conversations, without realizing or being concerned about their behavior.
Uncharacteristic or decreased ability to manage their money or monthly bills.
Making up answers to things while believing what they are saying is true.
Exhibiting poor decision-making, decreased self-care, and quickness to anger when their forgetfulness is brought up.

Anosognosia and caregiving

Anosognosia can be challenging in people with Alzheimer's disease and other dementias. Our loved ones can be completely convinced they are healthy. They may even refuse medications, treatments, and medical evaluations. This can lead to extreme frustration among caregivers.

Here are a few tips to help caregivers relate better to their loved one with Alzheimer's disease and anosognosia:³

Provide structure and a schedule of daily tasks.
Work together on money management and cleaning tasks.
Remain focused and calm when voicing any concerns.
Schedule activities and appointments in the morning when possible, when your loved one is more rested.
As always, be gentle, empathetic, and encouraging.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The AlzheimersDisease.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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isabella Member
 My husband was diagnosed with early onset Parkinson's disease at 57.his symptoms were shuffling of feet,slurred speech, low volume speech, degradation of hand writing, horrible driving skills, right arm held at 45 degree angle, things were tough for me, but now he finally free from the disease with the help of total cure ultimate health home, he now walks properly and all symptoms has reversed, he had trouble with balance especially at night, getting into the shower and exiting it is difficult,getting into bed is also another thing he finds impossible.we had to find a better solution for his condition which has really helped him a lot,the biggest helped we had was ultimatehealthhome they walked us through the proper steps,am highly recommended this ultimatehealthhome@gmail.com to anyone who needs help.
isabella Member
 My husband was diagnosed with early onset Parkinson's disease at 57.his symptoms were shuffling of feet,slurred speech, low volume speech, degradation of hand writing, horrible driving skills, right arm held at 45 degree angle, things were tough for me, but now he finally free from the disease with the help of total cure ultimate health home, he now walks properly and all symptoms has reversed, he had trouble with balance especially at night, getting into the shower and exiting it is difficult,getting into bed is also another thing he finds impossible.we had to find a better solution for his condition which has really helped him a lot,the biggest helped we had was ultimatehealthhome they walked us through the proper steps,am highly recommended this ultimatehealthhome@gmail.com to anyone who needs help.
1. Lynn Marie Witt, MSOT Moderator & Contributor
 <inline-mention username="isabella" user-id="2483905"/> thanks so much for reaching out and for taking the time to read my article. I am sorry to hear about your husband's early onset Parkinson's disease at 57 years of age. I am so glad you husband has improved. Everyones journey is so very different. SO very glad you found something that helped. Appreciate you sharing. Just Keep Swimming...Lynn Marie, "AlzheimersDisease.net Team Member"