The Persistence of the Self over Time in Mild Cognitive Impairment and Alzheimer's Disease

Tippett, Lynette J.; Prebble, Sally C.; Addis, Donna Rose

doi:10.3389/fpsyg.2018.00094

Cited by 26 publications

(28 citation statements)

References 84 publications

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“…Discontinuity was less frequent in our sample than the 50% reported in the one previous small-scale study of this phenomenon among people with dementia [ 17 ]; discontinuity was reported by half of the participants with Alzheimer’s disease ( n = 14) and half of the age-matched healthy controls ( n = 25). Given that the group of people with dementia in this earlier study both included participants with more extensive cognitive impairments (MMSE score of 10 and above) and found that those who provided more sophisticated explanations for their response to the continuity question were more likely to report a subjective sense of discontinuity, one might perhaps have expected to see higher levels of discontinuity in the present sample.…”

Section: Discussioncontrasting

confidence: 73%

“…For people with dementia, the more generally-worded question inviting comparison with the ‘person you have always been’ may be more likely to invite comparison with the pre-dementia self in the relatively recent past, and hence provide a more representative estimate of the extent to which people experience a sense of discontinuity as they develop and live with mild-to-moderate dementia. Further research could explore the issues associated with the question used in our study and the version used by Tippett and colleagues [ 17 ] in more detail in order to provide a clearer picture of the phenomenon elicited and allow for comparisons between people with dementia and older people without dementia.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to dementia, a comprehensive review [ 9 ] concluded that the epistemological self is largely maintained in people with mild-to-moderate dementia. Although aspects of episodic and autobiographical memory are affected, resulting for example in less temporal coherence within generated life narratives [ 17 ], there are few differences in measures of the epistemological self between people with mild-to-moderate dementia and age-matched healthy controls [ 18 ], little change in measures of the epistemological self over a 20 month follow-up period [ 19 ] and no linear relationship between decline in cognitive functioning and deterioration in the epistemological self over time [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Qualitative research indicates that while many individuals feel they are still the same person despite the challenges of living with dementia and the losses involved, others feel that dementia has affected them and their lives to the extent that they are not the same person as before [ 21 ]. There has been one in-depth investigation of diachronic unity in a small sample of 14 people with mild-to-moderate Alzheimer’s disease [ 17 ], using self-persistence and life-story interviews. The self-persistence interview began with the question ‘Do you feel that you are the same person now as you were when you were in your 20s?’ taken from a previous study of diachronic unity among older people [ 16 ]; responses from the participants with Alzheimer’s disease were equally divided between ‘yes’ and ‘no’.…”

Section: Introductionmentioning

confidence: 99%

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Discontinuity in the Subjective Experience of Self Among People with Mild-To-Moderate Dementia Is Associated with Poorer Psychological Health: Findings from the IDEAL Cohort

Clare

Martyr

Morris

et al. 2020

JAD

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Background: The onset and progression of dementia can result in changes in the subjective experience of self, impacting on psychological health. Objective: We aimed to explore the extent to which people with mild-to-moderate dementia experience discontinuity in the subjective experience of self, and the factors associated with this experience for people with dementia and their family caregivers. Methods: We used data from the baseline assessment of the IDEAL cohort. Discontinuity in the subjective experience of self was assessed by asking participants about their agreement with the statement ‘I feel I am the same person that I have always been’. Participants were divided into those who did and did not experience discontinuity, and the two groups were compared in terms of demographic and disease-related characteristics, psychological well-being, measures of ‘living well’, and caregiver stress. Results: Responses to the continuity question were available for 1,465 participants with dementia, of whom 312 (21%) reported experiencing discontinuity. The discontinuity group experienced significantly poorer psychological well-being and had significantly lower scores on measures of ‘living well’. There was no clear association with demographic or disease-related characteristics, but some indication of increased caregiver stress. Conclusion: A significant proportion of people with mild-to-moderate dementia describe experiencing discontinuity in the subjective sense of self, and this is associated with poorer psychological health and reduced ability to ‘live well’ with the condition. Sensitively asking individuals with dementia about the subjective experience of self may offer a simple means of identifying individuals who are at increased risk of poor well-being.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Discontinuity in the Subjective Experience of Self Among People with Mild-To-Moderate Dementia Is Associated with Poorer Psychological Health: Findings from the IDEAL Cohort

Clare

Martyr

Morris

et al. 2020

JAD

Self Cite

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“…In our scenario, changes in memory are considered universal and all-or-nothing. In real life, however, memories of self or self-knowledge seem to be better preserved than other knowledge, even in semantic dementia [20], and a subjective belief of self-persistence is demonstrated by patients with Alzheimer's disease [150]. Alternatively, the sense of self may be impaired while episodic memories stay intact-as in the case of R.B.…”

Section: Dimensions Of Closenessmentioning

confidence: 99%

Putting your money where your self is: Connecting dimensions of closeness and theories of personal identity

2020

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Studying personal identity, the continuity and sameness of persons across lifetimes, is notoriously difficult and competing conceptualizations exist within philosophy and psychology. Personal reidentification, linking persons between points in time is a fundamental step in allocating merit and blame and assigning rights and privileges. Based on Nozick's (1981) closest continuer theory we develop a theoretical framework that explicitly invites a meaningful empirical approach and offers a constructive, integrative solution to current disputes about appropriate experiments. Following Nozick, reidentification involves judging continuers on a metric of continuity and choosing the continuer with the highest acceptable value on this metric. We explore both the metric and its implications for personal identity. Since James (1890), academic theories have variously attributed personal identity to the continuity of memories, psychology, bodies, social networks, and possessions. In our experiments, we measure how participants (N = 1, 525) weighted the relative contributions of these five dimensions in hypothetical fission accidents, in which a person was split into two continuers. Participants allocated compensation money (Study 1) or adjudicated inheritance claims (Study 2) and reidentified the original person. Most decided based on the continuity of memory, personality, and psychology, with some consideration given to the body and social relations. Importantly, many participants identified the original with both continuers simultaneously, violating the transitivity of identity relations. We discuss the findings and their relevance for philosophy and psychology and place our approach within the current theoretical and empirical landscape. OPEN ACCESS Citation: Woike JK, Collard P, Hood B (2020) Putting your money where your self is: Connecting dimensions of closeness and theories of personal identity. PLoS ONE 15(2): e0228271. https://doi. Data Availability Statement: The data required to replicate the results of this study for both Study 1 and Study 2 can be accessed in the Harvard Dataverse (https://doi.org/10.7910/DVN/AN1QF3). The dataset for Study 1 is freely accessible in a Personal identity and reidentificationThis investigation into personal identity starts with a theoretical analysis of reidentification. Reidentification poses an important question concerning personal identity [1,18]: Is y at t 2 one and the same person as x at t 1 ? We recognize and thereby reidentify acquaintances and connect their present state with earlier states, but we are also able to remember or imagine their existence in the past and the future. Furthermore, we each stand in a special relationship Putting your money where your self is PLOS ONE | https://doi.org/10.1371/journal.pone.0228271 February 12, 2020 2 / 44 version without demographic information and can be requested via the platform with demographic data by researchers at academic institutions upon reasonable request (the full dataset is uploaded to the platform).

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Autobiographical memory in dementia syndromes—An integrative review

Irish

2022

WIRES Cognitive Science

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Autobiographical memory represents a defining feature of human cognition, enabling us to vividly re‐experience salient events from the personal past. By mentally traversing different temporal contexts, humans can maintain an enduring sense of who we are as individuals, as well as envisaging our future goals and behaviors. The relative ease with which we engage in these endeavors, however, belies the remarkable complexity of the autobiographical memory system. Dementia syndromes offer compelling insights into the cognitive neuroarchitecture of autobiographical memory in the face of progressive neural insult to large‐scale brain networks. Importantly, the atrophy profiles of many neurodegenerative disorders follow coordinated and predictable trajectories, affecting key regions implicated in episodic and semantic memory. A wealth of evidence suggests that autobiographical memory disruption is a transdiagnostic feature of dementia, yet this impairment takes many forms and arises due to differential neurocognitive disturbances. This review aims to provide a comprehensive overview of the literature on autobiographical memory in typical and atypical presentations of Alzheimer's disease, as well as younger‐onset dementia syndromes such as frontotemporal dementia and primary progressive aphasia. I will demonstrate how the systematic study of autobiographical memory across dementia syndromes can constrain and inform our fundamental understanding of memory function and, in turn, stimulate new directions in how we conceptualize and assess these cognitive capacities. Consideration will further be given to clinical implications of autobiographical memory dysfunction with a view to developing targeted interventions to better support the person living with dementia. This article is categorized under: Psychology > Memory Neuroscience > Clinical Neuroscience Psychology > Brain Function and Dysfunction

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The Persistence of the Self over Time in Mild Cognitive Impairment and Alzheimer's Disease

Cited by 26 publications

References 84 publications

Discontinuity in the Subjective Experience of Self Among People with Mild-To-Moderate Dementia Is Associated with Poorer Psychological Health: Findings from the IDEAL Cohort

Discontinuity in the Subjective Experience of Self Among People with Mild-To-Moderate Dementia Is Associated with Poorer Psychological Health: Findings from the IDEAL Cohort

Putting your money where your self is: Connecting dimensions of closeness and theories of personal identity

Autobiographical memory in dementia syndromes—An integrative review

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