Awareness of Psychiatric Symptoms in a Mixed Clinical Sample of Older Adults

J Geriatr Psychiatry Neurol. 2020 May;33(3):124-134. doi: 10.1177/0891988719868311. Epub 2019 Aug 11.


Objective: This study examined the neuropsychological correlates and impact on caregiver distress of reduced awareness of mood symptoms in patients with suspected neurodegenerative disease.

Method: Records from a clinical sample of older adults were examined (N = 940).

Results: More than one-third of patient and caregiver ratings of mood symptoms did not agree (comparing patient and caregiver self-report measures); 27.9% of patients were unaware of depression (UoD) and 16.6% of patients were unaware of anxiety (UoA). The UoD group exhibited poorer verbal memory and executive abilities and the UoA group exhibited poorer verbal memory than those with preserved awareness. Unawareness was not associated with caregiver distress.

Conclusions: These findings highlight the importance of capturing informant report in clinical practice with older adults suspected of cognitive impairment. Unawareness of mood symptoms was related to memory dysfunction and-to a lesser extent-to executive abilities and may have implications for addressing patient and caregiver needs for disorders affecting these cognitive systems.

Keywords: awareness; caregiver distress; executive functioning; memory; neurodegeneration; neuropsychiatric symptoms.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Affect
  • Aged
  • Aged, 80 and over
  • Anxiety / psychology
  • Awareness / physiology*
  • Caregivers / psychology
  • Cognitive Dysfunction / psychology*
  • Female
  • Humans
  • Male
  • Memory
  • Memory Disorders / psychology
  • Mental Disorders / psychology*
  • Middle Aged
  • Neurodegenerative Diseases
  • Neuropsychological Tests
  • Self Report