clinical associations of anosognosia in mild cognitive impairment and alzheimers disease aims and objective while loss of insight of cognitive deficits is a common phenomenon in patients with alzheimers disease ad there is a lack of consensus regarding the presence of impaired insight among patients with mild cognitive impairment mci we aim to investigate the clinical cognitive and behavioral associations of anosognosia in ad and mci subjectsmethods a consecutive series of 87 subjects 30 healthy older patients 21 mci and 36 ad each accompanied by a caregiver underwent clinical assessment including the evaluation of insight using the anosognosia questionnaire for dementia aqd we also separately assessed intellectual function aqdif and behavior domains of the aqd scale regression models were subsequently used to investigate associations of aqd scores with cognitive and other neuropsychiatric symptoms including depression and apathyresults both ad and mci groups demonstrated significant anosognosia compared with the healthy control group in the ad group 556 had mild anosognosia and 278 had severe anosognosia in the mci group 429 showed mild anosognosia and 95 had severe anosognosia greater levels of aqdtotal and aqdif were associated with lower minimental state examination and higher apathy scores in the ad group in the mci group caregiver burden was significantly associated with aqdtotal p0016 and aqdif p0039conclusion the results indicated that anosognosia is common in both ad and mci patients and associated with cognitive dysfunction and apathy in ad the findings of this study warrant further research to delineate the mechanisms of anosognosia as it poses a challenge to treatment outcomes