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Insight in dementia: when does it occur? Evidence for a nonlinear relationship between insight and cognitive status
Zanetti O, Vallotti B, Frisoni GB, Frisoni GB, Geroldi C, Bianchetti A, Pasqualetti P, Trabucchi M.. The journals of gerontology. Series B, Psychological sciences and social sciences, 1999-03-01
Topic: Risk, prevention and care in population studies
Lack of insight or impaired awareness of deficits in patients with dementia is a relatively neglected area of study. The aim of this study was to evaluate insight in a group of demented patients with two assessment scales and to assess their relationship with the cognitive level of disease severity. Sixty-nine consecutive patients affected by Alzheimer's disease (n = 37) and vascular dementia (n = 32) with a wide range of cognitive impairment (MMSE = 17.0 +/- 6.4) were recruited.
Key findings
- The aim of this study was to evaluate insight in a group of demented patients with two assessment scales and to assess their relationship with the cognitive level of disease severity.
- Sixty-nine consecutive patients affected by Alzheimer's disease (n = 37) and vascular dementia (n = 32) with a wide range of cognitive impairment (MMSE = 17.0 +/- 6.4) were recruited.
- Insight was evaluated with the Guidelines for the Rating of Awareness Deficits (GRAD)--specifically targeted to memory deficits--and the Clinical Insight Rating scale (CIR), evaluating a broader spectrum of insight (reason for the visit, cognitive deficits, functional deficits, and perception of the progression of the disease).
- In the whole sample, GRAD and CIR were significantly associated with MMSE (Spearman's coefficient = .51, p or = 24, showed a linear decrease between MMSE scores of 23 and 13, and was uniformly low for MMSE scores < or = 12.
Why it matters
This study looked at how aware patients with dementia are of their own memory problems, using two rating scales in 69 patients with Alzheimer's disease or vascular dementia. It found that this awareness relates to the level of cognitive impairment in a nonlinear way, which may help caregivers and clinicians understand when patients are likely to recognize their deficits.
Study details
- Participants37
- Evidence strengthLow
How this study scored 44/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The journals of gerontology. Series B, Psychological sciences and social sciences) |
| Journal's citation record | 2 / 4 | The Journals of Gerontology Series B: journal h-index 225 (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 | 1999 — older than 20 years, still counted |
| Sample size | 1 / 4 | 37 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 155 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.3 citations a year over 29 year(s) since 1999 |
| Impact for its field and year | 2 / 6 | Cited 2.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 1 / 4 | Cited 9 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Marco Trabucchi: h-index 68 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Florence: institution h-index 739 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 10097772) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 44 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Zanetti, O., Vallotti, B., Frisoni, G. B., Geroldi, C., Bianchetti, A., Pasqualetti, P., et al. (1999). Insight in dementia: when does it occur? Evidence for a nonlinear relationship between insight and cognitive status. The journals of gerontology. Series B, Psychological sciences and social sciences. https://doi.org/10.1093/geronb/54b.2.p100
Vancouver
Zanetti O, Vallotti B, Frisoni GB, Geroldi C, Bianchetti A, Pasqualetti P, et al. Insight in dementia: when does it occur? Evidence for a nonlinear relationship between insight and cognitive status. The journals of gerontology. Series B, Psychological sciences and social sciences. 1999. doi:10.1093/geronb/54b.2.p100. PMID: 10097772.
BibTeX
@article{zanetti1999-10097772,
author = {Zanetti, O. and Vallotti, B. and Frisoni, G. B. and Geroldi, C. and Bianchetti, A. and Pasqualetti, P. and Trabucchi, M.},
title = {{Insight in dementia: when does it occur? Evidence for a nonlinear relationship between insight and cognitive status}},
journal = {The journals of gerontology. Series B, Psychological sciences and social sciences},
year = {1999},
doi = {10.1093/geronb/54b.2.p100},
pmid = {10097772},
url = {https://doi.org/10.1093/geronb/54b.2.p100}
}
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