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However, there is a lack of consensus regarding the presence, as well as the evolution, of altered awareness of memory function across the preclinical and prodromal stages of AD. Here, we aimed to characterize change in awareness of memory abilities and its relationship to beta\u2010amyloid (A\u03b2) burden in a large cohort (N = 1,070) of individuals across the disease spectrum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Memory awareness was longitudinally assessed (average number of visits = 4.3) and operationalized using the discrepancy between mean participant and partner report on the Everyday Cognition scale (memory domain). A\u03b2 deposition was measured at baseline using [18F]florbetapir positron emission tomographic imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A\u03b2 predicted longitudinal changes in memory awareness, such that awareness decreased faster in participants with increased A\u03b2 burden. A\u03b2 and clinical group interacted to predict change in memory awareness, demonstrating the strongest effect in dementia participants, but could also be found in the cognitively normal (CN) participants. In a subset of CN participants who progressed to mild cognitive impairment (MCI), heightened memory awareness was observed up to 1.6\u2009years before MCI diagnosis, with memory awareness declining until the time of progression to MCI (\u22120.08 discrepant\u2010points\/yr<jats:italic>)<\/jats:italic>. In a subset of MCI participants who progressed to dementia, awareness was low initially and continued to decline (\u22120.23 discrepant\u2010points\/yr<jats:italic>)<\/jats:italic>, reaching anosognosia 3.2\u2009years before dementia onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>A\u03b2 burden is associated with a progressive decrease in self\u2010awareness of memory deficits, reaching anosognosia approximately 3\u2009years before dementia diagnosis. ANN NEUROL 2020;87:267\u2013280<\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.25649","type":"journal-article","created":{"date-parts":[[2019,11,21]],"date-time":"2019-11-21T10:49:01Z","timestamp":1574333341000},"page":"267-280","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":82,"title":["Evolution of anosognosia in alzheimer's disease and its relationship to amyloid"],"prefix":"10.1002","volume":"87","author":[{"given":"Bernard J.","family":"Hanseeuw","sequence":"first","affiliation":[{"name":"Department of Neurology, Cliniques Universitaires Saint\u2010Luc, and Institute of Neuroscience Catholic University of Louvain  Brussels Belgium"},{"name":"Department of Neurology and Radiology, Gordon Center for Medical Imaging Massachusetts General Hospital, Harvard Medical School  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Neurology and Radiology, Athinoula A. Martinos Center for Biomedical Imaging Massachusetts General Hospital, Harvard Medical School  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sietske A. M.","family":"Sikkes","sequence":"additional","affiliation":[{"name":"Department of Neurology and Radiology, Athinoula A. Martinos Center for Biomedical Imaging Massachusetts General Hospital, Harvard Medical School  Boston MA"},{"name":"Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience Amsterdam University Medical Center, VU University  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Properzi","sequence":"additional","affiliation":[{"name":"Department of Neurology and Radiology, Athinoula A. 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