Do people with Alzheimer’s know they have it?

Many people have raised the question, “do people with Alzheimer’s know they have it?”

You might be surprised to learn that some people are not aware that they have Alzheimer’s. 

People with Alzheimer’s, dementia, a brain tumour, stroke, and other types of damage in the brain are cognitively impaired and might not believe anything is wrong with them. Sometimes, this is caused by a condition called anosognosia.  The meaning of anosognosia is ‘to not know a disease’ and is not the same as being in denial.

Anosognosia = someone who does not understand that something is wrong

Anosognosia causes someone not to be aware of their health condition. It’s common in some cognitive conditions, including Alzheimer’s. 

If someone diagnosed with Alzheimer’s also has anosognosia, they won’t know or believe that they have it. Each person is unique, so the symptoms of anosognosia might vary. Symptoms may also change over time and even during a single day. For example, a person might sometimes understand what is going on and other times believe that they are fine. 

Because of this inconsistent behaviour, some family and friends might not even know that there’s something wrong even if they notice that some behaviours seem unusual.

Anosognosia and denial are not the same things

When someone is in denial, they’re aware of a fact but refuse to accept it. But with anosognosia, someone with Alzheimer’s is not in denial. On the contrary, they are not even aware that they’re cognitively impaired. The disease has damaged their brain and makes it impossible for them to know what’s happening.

 Symptoms of anosognosia

Not being aware of their cognitive impairment can show up in someone’s understanding of their own memory, general thinking skills, emotions, or physical abilities. For example, they might have trouble with language, like not being able to find the words for everyday objects or simple tasks. However, they might try to explain these situations by saying they just forgot or are tired.

Or, if they miss an appointment, forget to change dirty clothes or leave food unrefrigerated, they will probably still make excuses and insist that there’s nothing wrong. And even if it’s evident to others that they need help, they will likely insist that they’re just fine and able to care for themselves. They might even get angry or defensive if you remind them about

their cognitive impairment because they are convinced there is no problem.