A-77: Insight Into Mood Symptoms in Mild Cognitive Impairment (Alzheimer’s Vs Vascular Etiology)

Abstract

Objective: Insight (anosognosia) deficits are commonly observed in neurodegenerative disease and may affect the reliability of patient self-report of mood symptoms. Although anosognosia is well documented in Alzheimer’s disease (AD), less is known about whether awareness of mood symptoms differs between different etiologies. This study examined whether concordance between patient- and caregiver-reported mood symptoms differs by MCI etiology as one index of mood awareness. Method/Data Selection: Participants included 137 individuals diagnosed clinically with MCI attributed to AD (n = 43) or vascular etiology (n = 94). Patient-reported depression and anxiety were measured using the Geriatric Depression Scale (GDS) and Geriatric Anxiety Scale (GAS). Caregiver-reported mood symptoms were measured using the Neuropsychiatric Inventory (NPI). Cohen’s κ was used to examine agreement between patient and caregiver-reported mood symptoms across etiologies. Results/Data Synthesis: Agreement was small for depression (AD: κ=.288, p=.018, vascular: κ=.236, p=.015) and anxiety (AD: κ=.285, p=.06, vascular: κ=.279, p=.006), though AD anxiety kappa was not statistically significant. Kappa values did not significantly differ between groups for depression (z = 0.32, p = .75) or anxiety (z = 0.03, p = .97), indicating similarly low concordance across etiologies. Conclusions: Patient-caregiver agreement on depression and anxiety symptoms was similarly modest and did not differ significantly between AD and vascular MCI groups. These findings suggest MCI diagnosis may not substantially influence concordance of mood reporting. Patient self-report remains clinically informative in MCI, though agreement with caregiver ratings is limited.