Understanding the individual with Alzheimer’s disease: Can socioemotional selectivity theory guide us?

Abstract

Individuals often get lost behind the diagnosis of Alzheimer's disease (AD) while widespread differences between these patients are more common than similarities. Socioemotional Selectivity Theory (SST) suggests that as we age our goals change from future-oriented (acquiring new information) to present-oriented (enhancing the emotional, especially positive, meaning of encounters). The goal of the current article is to examine whether the principles of SST might also apply for people with AD. Some aspects of SST are found especially in the early stages of AD when awareness is often intact and cognitive impairment is relatively limited. This review has clinical significance for the treatment of AD because it focuses on what is important to the individual rather than treating patients as a homogenous group. It also highlights the importance of social networks and emphasizes the role of the proxy in AD care. Lastly, it suggests that if those with AD (like the healthy elderly) have a positivity bias then positive emotional stimuli/ wording/instructions could usefully be employed in their daily treatment. I suggest that SST may be a useful starting point when attempting to address what matters to individuals with AD and conclude by providing a few suggestions for future studies.

Perceptions of stigma among people affected by early- and late-onset Alzheimer’s disease

“…For instance, people focused on considering the friends and family who remained supportive and felt that they were lucky relative to others. The findings provide support for socioemotional selectivity theory and in population of people with Alzheimer’s disease (Mark, 2012). The underlying premise of the theory being that as we age, our motivational goals change from seeking knowledge-focused experiences to more emotion-led experiences (Carstensen et al, 1991), essentially ‘making the most of the time we have’.…”

“…It would be of great interest to explore whether similar perceptions of stigma are reported in people experiencing more ‘advanced’ symptoms of Alzheimer’s disease, particularly given the increased visibility of symptoms and potential ‘intrusiveness’ (Chaudoir et al, 2013; Hellstrom and Torres, 2013). Furthermore, it would provide useful insights into whether people with more ‘advanced’ symptoms of Alzheimer’s disease are able to employ the same positivity biases to cope with experiences as participants in this research (Mark, 2012; Reed and Carstensen, 2012).…”

“…Alzheimer's disease (Mark, 2012). The underlying premise of the theory being that as we age our motivational goals change from seeking knowledge-focused experiences, to more emotion-led experiences (Carstensen et al, 1991), essentially 'making the most of the time we have'.…”

Looking ahead to a future with Alzheimer's disease: coping with the unknown

“…SST (Carstensen, 1991) predicts that people affected by ‘time-limiting’ conditions, in this case Alzheimer's disease, will have a similar sense of time being restricted. If Alzheimer's disease were not present, older participants would be expected to have a different view of time to younger participants (Carstensen et al , 1999; Mark, 2012); whereas, the presence of Alzheimer's disease leads to a shift in focus from knowledge-focused to emotion-focused goals. Overall, this can be seen to influence how younger and older participants managed their experiences.…”

Meaningful activities for improving the wellbeing of people with dementia: beyond mere pleasure to meeting fundamental psychological needs

“…Application of such theories would strengthen the case for the provision of meaningful activities that benefit the psychological wellbeing of people with dementia and their carers. We build on a recent argument to connect a developmental psychological theory with the management of people with dementia, 21 and add to previous arguments for the public health benefits of pleasurable activities such as visiting museums, art galleries 22 and exposure to plants and green spaces. 23 For the first time, we connect existing initiatives to facilitate participation of people with dementia in meaningful activities with psychological theory.…”