Anosognosia and Other Clinical Terms Defined

I was recently leading one of our monthly support groups for HABIT alumni when the topic of psychological denial (the unwillingness to admit one has a problem) vs. anosagnosia (the inability to SEE that one has a problem) came up. Despite the fact that this was  group of alumni who had been through the HABIT program, the difference between these constructs was still difficult to entirely absorb and led to a further discussion about the definition of this clinical term, "anosagnosia". That led to the idea for this post--A glossary of sorts of clinical terms that one might hear that describe symptoms of MCI. So here goes!

• Anosognosia: We talk about this one a lot in HABIT. Anosognosia is the inability, in a neurologic sense, to be aware of impairment. We will contrast this with psychological denial, or an inability to accept or admit one has impairment. Or put another way, it isn't that our patients won't admit MCI, it is that they can't entirely see it. Now, many of my patients (including some of you reading this blog) are very much aware and able to see your MCI symptoms. But some can't and I want your partners to know this isn't intentional or a choice. Understanding this can sometimes help our patients and partners understand why they may see things differently from one another and have compassion for one another.

• Confabulation. Sometimes we will hear partners say things like. "She makes up stories that aren't true." or "Why does he have to lie about something that happened." The idea is that some patients with MCI will describe events inaccurately or even describe events that never happened. This is confabulation. It is not intentional lying. It is a neurologic issue when the brain serves up a memory that, to the person, feels true but is not. Our recommendation when this happens is to let it go unless there is a safety issue.

• Perseveration. This one is often a bit more familiar to people. This is the idea that someone may "get stuck" on one topic or idea. They may talk about a certain topic over and over. Or they may perform the same behavior repeatedly. Sometimes this is because a patient cannot remember they already said something or did something, but sometimes it is perseveration in that the person's mind just has a hard time moving away from the topic or behavior. At times, offering a distracting activity can help the brain let go.

• Visual agnosia. This one is a bit more atypical or rare, but visual agnosia is essentially being unable to recognize or make meaning of what one sees. This is not a vision issue--The eyes are working fine. It is a brain issue where the brain cannot properly translate the visual input. Simultagnosia is a type of visual agnosia that is difficulty finding one object in a crowded or cluttered space. For example, being able to "see" a set of tongs in a drawer crowded with cooking utensils.  Another specific type of visual agnosia is prosopagnosia, which is the inability to recognize familiar faces. In these circumstances individuals may be able to recognize individuals by their voice or other non-facial body features. Alexia is a visual agnosia that is the inability to recognize words,

This is a start—What other terms have you heard you’d like me to add? Just let me know in the comments and I’ll do my best to revise this entry with an explanation!