Some individuals with dementia remain unaware of their cognitive decline throughout the illness, while others are acutely aware and may suffer more due to this insight.

“sometimes people are always blissfully unaware throughout the entire course of their illness you know i can't tell you how many times you know i see a patient and they sit down in my office and i'm like so what brings you in today and they're like my wife because there's nothing wrong with me i'm fine they have no idea why they're there even in the very mild stages whereas some people are so acutely aware that something's not right and sometimes they know for two or three years before we can even find any discernible changes on their testing you know they're like i know something's wrong with me”