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48/100

✓ Peer-reviewed alzhub usefulness score 48 out of 100. Caregiving

Topic: Amyloid, tau and blood-test diagnosis

Plain-language summary

Objective To determine the earliest symptoms of anosognosia in people with Alzheimer's disease and to validate a criteria-guided strategy to diagnose anosognosia in dementia. Methods A consecutive series of 750 patients with very mild or probable Alzheimer's disease attending a memory clinic, as well as their respective care givers, was assessed using a comprehensive psychiatric evaluation. Results The factors of anosognosia for (1) basic activities of daily living (bADL), (2) instrumental activities of daily living (iADL), (3) depression and (4) disinhibition were produced by a principal component analysis on the differential scores (ie, caregiver score minus patient score) on the anosognosia questionnaire for dementia. A discrepancy of two or more points in the anosognosia-iADL factor was found to have a high sensitivity and specificity to identify clinically diagnosed anosognosia in people with Alzheimer's disease. By logistic regression analysis, the severity of dementia and apathy were both shown to be noticeably associated with anosognosia in people with Alzheimer's disease. Conclusion Anosognosia in those with Alzheimer's disease is manifested as poor awareness of deficits in iADL and bADL, depressive changes and behavioural disinhibition. The frequency of anosognosia is found to increase considerably with the severity of dementia. The validity of a specific set of criteria to diagnose anosognosia in people with Alzheimer's disease was shown, which may contribute to the early identification of this condition.

What this study adds

Evidence grade: Low

The record lists 750 participants. This study describes a way to diagnose anosognosia (poor awareness of one's own deficits) in Alzheimer's disease by comparing caregiver and patient reports, especially about instrumental daily activities. It found that this lack of awareness becomes more common as dementia gets more severe, which matters for how care is assessed and managed.

Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Starkstein, S. E., Jorge, R., Mizrahi, R., & Robinson, R. G. (2006). A diagnostic formulation for anosognosia in Alzheimer's disease. Journal of neurology, neurosurgery, and psychiatry. https://doi.org/10.1136/jnnp.2005.085373

Vancouver

Starkstein SE, Jorge R, Mizrahi R, Robinson RG. A diagnostic formulation for anosognosia in Alzheimer's disease. Journal of neurology, neurosurgery, and psychiatry. 2006. doi:10.1136/jnnp.2005.085373. PMID: 16549411.

BibTeX

@article{starkstein2006-16549411,
  author  = {Starkstein, S. E. and Jorge, R. and Mizrahi, R. and Robinson, R. G.},
  title   = {{A diagnostic formulation for anosognosia in Alzheimer's disease}},
  journal = {Journal of neurology, neurosurgery, and psychiatry},
  year    = {2006},
  doi     = {10.1136/jnnp.2005.085373},
  pmid    = {16549411},
  url     = {https://doi.org/10.1136/jnnp.2005.085373}
}

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How to read this study

Design: our record does not state a study design, so check the methods section of the original before weighing the result.
Size: the record lists 750 participants. Ask whether that is enough for the question, and who they were.
Effect: the record gives no effect size, so the summary above cannot say how large any difference was.

What the evidence grade means here

This page is graded low. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. Low means the abstract matched neither pattern. It is the default label, and it does not mean the work is poor; many sound lab and imaging papers land here. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

Results The factors of anosognosia for (1) basic activities of daily living (bADL), (2) instrumental activities of daily living (iADL), (3) depression and (4) disinhibition were produced by a principal component analysis on the differential scores (ie, caregiver score minus patient score) on the anosognosia questionnaire for dementia.
By logistic regression analysis, the severity of dementia and apathy were both shown to be noticeably associated with anosognosia in people with Alzheimer's disease.

Why it matters

This study describes a way to diagnose anosognosia (poor awareness of one's own deficits) in Alzheimer's disease by comparing caregiver and patient reports, especially about instrumental daily activities. It found that this lack of awareness becomes more common as dementia gets more severe, which matters for how care is assessed and managed.

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Study details

Participants750
Evidence strengthLow

How this study scored 48/100

Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of neurology, neurosurgery, and psychiatry)
Journal's citation record	3 / 4	Journal of Neurology Neurosurgery & Psychiatry: journal h-index 336 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2006 — older than 20 years, still counted
Sample size	2 / 4	750 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	5 / 7	Cited 238 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	10.8 citations a year over 22 year(s) since 2006
Impact for its field and year	3 / 6	Cited 4.4× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	2 / 6	Cited by 3 other studies in this library
Still being cited	2 / 4	Cited 23 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author SERGIO E. STARKSTEIN: h-index 22 (OpenAlex, whole career)
Institution's track record	1 / 3	The University of Western Australia: institution h-index 1,026 (OpenAlex)
Multicenter collaboration	1 / 3	OpenAlex lists 2 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 16549411)
Free to read	0 / 2	Behind a paywall — scores zero
Total	48 / 100	—

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