The impact of dementia on self and identity: A systematic review

doi:10.1016/j.cpr.2009.10.003

Clinical Psychology Review

Volume 30, Issue 1, February 2010, Pages 113-126

https://doi.org/10.1016/j.cpr.2009.10.003 Get rights and content

Abstract

There is much debate in the literature as to the extent to which self and identity persist in people with dementia. The aim of this systematic review was to examine methods currently used to investigate self and identity in people with dementia, and the resulting evidence as to the persistence of self and identity throughout the course of the disease. Thirty-three studies were reviewed, which showed that many approaches have been taken to studying aspects of self and identity in dementia, including both quantitative and qualitative methods. This appears to be partly due to the differing underlying concepts of self that have been used as a basis for these studies. Consequently, results obtained from these studies are somewhat disparate, although it is possible to draw some tentative conclusions from the available evidence. Almost all of the studies suggest that there is at least some evidence for persistence of self in both the mild and moderate to severe stages of the illness, although many studies record some degree of deterioration in aspects of self or identity. Further research is required to clarify existing evidence and to address outstanding questions regarding self and identity in dementia.

Section snippets

Method

The databases PsycINFO, MEDLINE, CINAHL, ASSIA, and Caredata were searched on 16th March 2009, using the terms “self”, “identity”, “personhood” and “selfhood” with either “Alzheimer's disease” or “dementia” in the article title. Reference sections of the identified papers were scrutinised for additional relevant studies.

The criteria for the inclusion of studies in the review were:

•
Study participants have a diagnosis of dementia (including fronto-temporal dementia, Alzheimer's disease, vascular

Results

Thirty-three studies met the inclusion criteria for the review. These are summarized in Table 1. The methodologies used in these studies and the resulting evidence are described below, according to the model of self or identity used in each study, and are grouped into qualitative and quantitative approaches.

Discussion

The aim of this review was to examine the methods used to study self in dementia, the resulting evidence regarding the persistence of self throughout the course of the disease, and the implications for future research. It can be seen that both qualitative and quantitative methods have been used to study self in dementia, and that even within these two domains, methodologies have varied considerably. Consequently, results obtained from these studies are rather disparate, but it is possible to

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View full text

The impact of dementia on self and identity: A systematic review

Abstract

Section snippets

Method

Results

Discussion

Journal of Aging Studies

Comprehensive Psychiatry

Social Science and Medicine

Social Science and Medicine

Social Science and Medicine

Social Science and Medicine

Journal of Psychiatric Research

Journal of Aging Studies

Journal of Aging Studies

Neurobiology of Aging

Social Science and Medicine

Journal of Aging Studies

Memory of myself: Autobiographical memory and identity in Alzheimer's disease

Memory

A propos de quelques conduits devant le miroir de sujets atteints de syndromes dementiels du grand age

Neuropsychologia

Self-recognition in Alzheimer's disease: A mirror and video study

Journal of Gerontology: Psychological Sciences

Self-recognition in senile dementia

Experimental Aging Research

Symbolic interactionism: Perspective and method

Self-recognition in Alzheimer's disease: Evidence of an explicit/implicit dissociation

Clinical Gerontologist

Covert versus overt recognition in late stage Alzheimer's disease

Journal of the International Neuropsychological Society

Mirrored-self misidentification: Two cases of focal onset dementia

Neurocase

Life as narrative

Social Research

Body image aberration in Schizophrenia

Journal of Abnormal Psychology

Utilisation of self-identity roles for designing interventions for persons with dementia

Journal of Gerontology: Psychological Sciences

Persistence of self in individuals with Alzheimer's disease

Dementia

Tennessee Self-Concept Scale

Alzheimer's disease victims; The ‘unbecoming’ of self and the normalization of competence

Sociological Perspectives

The social constructionist movement in modern psychology

American Psychologist

Self-consciousness and Alzheimer's disease

Acta Neurologica Scandinavica