Negative stereotypes, fear and social distance: a systematic review of depictions of dementia in popular culture in the context of stigma

Abstract

Background Literature, film and news media reflect and shape social perceptions of dementia which in turn impact on dementia stigma. The aim of this paper is to systematically review papers on the depiction and frames for dementia in literature, film, mass media and social media in order to better understand cultural stigma related to dementia. Methods A systematic search of electronic databases was undertaken combining phrases relating to dementia, popular culture and representations, and phrases relating to dementia and stigma. We searched for scientific English language papers which included original analysis on the representation or depiction of dementia in popular culture (i.e. in film and television, literature, news, social media and language). Articles published between 1989–2018 were included. The search was conducted in December 2017 and updated in January 2019. Inductive thematic synthesis was undertaken. Results A total of 60 articles were included from an initial sample of 37022. Dementia was almost always depicted in conjunction with ageing, and often equated with Alzheimer’s disease. Common frames for dementia were biomedical - dementia involves the deterioration of the brain for which there is no current cure; natural disaster or epidemic - dementia is a force of nature which will overwhelm mankind; and living dead – people with dementia lose their brains, memories, minds and consequently their personhood and human rights. There were examples of more positive depictions of dementia including expressing love and individual agency and experiencing personal growth. Feelings commonly associated with dementia were fear, shame, compassion and guilt, and depictions often resulted in a sense of social distance. Conclusions Depictions of dementia in popular culture are associated with negative images and feelings, and social distance between people with dementia and those without. These correspond to dementia stigma in the public and as experienced by people with dementia. Further research is needed into the impact of literature, news and social media on dementia stigma and these cultural mediums might be used to reduce stigma.

The Experts’ Advice: Prevention and Responsibility in German Media and Scientific Discourses on Dementia

“…The responsibility for cognitive health and the blame for cognitive decline in old age might be shifted onto those who do not follow health and prevention recommendations and thus fail or refuse to live their lives in a healthy, active, and socially acceptable manner (Forlini & Hall, 2017). In interaction with degrading and objectifying images of dementia (Harvey & Brookes, 2019;Low & Purwaningrum, 2020), the strong emphasis on individual responsibility might support "victim-blaming of those living with dementia and result in increased stigmatization" (Lawless et al, 2018(Lawless et al, , p. 1548; see also Harris et al, 2016;Mohr et al, 2021;Peel, 2014). The responsibilization of cognitive aging could hence contribute to new forms of ageisms which replace the earlier general angst of aging with a specific fear of frailty, inability, and loss of cognitive abilities (Holstein & Minkler, 2003), and reinforce a devaluation of those who, due to physical and cognitive decline, can no longer comply with the ideal of self-reliant, successful aging.…”

Dementia in Media Coverage: A Comparative Analysis of Two Online Newspapers across Time

“…Some corresponding titles are: ‘I have to treat patients like objects: the harsh reality of working in dementia care’ (the GDN); ‘Living with the patients I’m losing to AD’ (the NYT). It can thus be further suggested that both newspapers are more likely to report on the care need or caregiving burden of dementia, which in turn impacts on the dementia-related social stigma [ 56 ]. Consequently, help-seeking behavior may be delayed, healthcare professionals may be reluctant to give a dementia diagnosis, and the overall human rights of people with dementia may be violated [ 69 , 70 ].…”

“…The depiction and prevalent contextualization of dementia in the news media is typically negative, which in turn impacts on public stigma, negative feelings, and social distance [ 55 , 56 ]. It further generates stereotypical images of PlwD that they are not fully human, are incompetent, and are burdens on society.…”

Carer Empowerment Is Key to Reduce Dementia Care Inequalities in the Middle East

“…In the Middle East, a more spiritual and deterministic view of health and illness is used [ 13 , 14 ]. This attitude potentially contributes to stigmatization and reduces help-seeking behaviors [ 8 ]. Additional obstacles in studying dementia perceptions and engaging with dementia carers in the Middle East include language barriers, a lack of knowledge, lack of informal support outside of hospitals, and over-dependence on clinicians for dementia information [ 1 ].…”

“…A major problem faced by individuals living with dementia and their carers is stigmatization [7]. A stigma, or the process of stigmatization, refers to a sense of shaming or externally induced embarrassment regarding some characteristic [8]. Broad social and cultural shaming of mental health issues can reduce help-seeking behaviors and may cause embarrassment to adults with dementia, their families, and carers [4].…”