This article explores the relationship between lack of awareness of neuropsychological deficit, also termed anosognosia, and loss of self knowledge in Alzheimer's disease (AD). Specifically, it considers the hypothesis that anosognosia in AD can in part be explained by a loss of mnemonic ability in which knowledge about self-ability is degraded. To ground this hypothesis, we review evidence suggesting failure to update personal knowledge concerning task efficacy, loss of recollection with relative amplification of semanticization processes and loss of an updated representation of the self. We present a theoretical formulation as to how the features of memory impairment in AD may contribute to anosognosia, incorporating these notions in a reformulation of the Cognitive Awareness Model.
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