Sense of identity in advanced Alzheimer’s dementia: A cognitive dissociation between sameness and selfhood?

• Published in: Consciousness and cognition 2013-12, Vol.22 (4), p.1456-1467
• Main Authors: Eustache, M.-L., Laisney, M., Juskenaite, A., Letortu, O., Platel, H., Eustache, F., Desgranges, B.
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Aged; Aged, 80 and over; Alzheimer Disease - psychology; Alzheimer's disease; Biological and medical sciences; Case-Control Studies; Cognitive psychology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Female; Humans; Identity; Life Sciences; Male; Medical sciences; Neurology; Neurons and Cognition; Organic mental disorders. Neuropsychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sameness; Self; Self Concept; Selfhood; Sense of identity; Severity of Illness Index
• ISSN: 1053-8100; 1090-2376
• DOI: 10.1016/j.concog.2013.09.009

•Sense of identity is partly preserved even in advanced stage of Alzheimer’s dementia.•Patients’ self-descriptions remained consistent over a two-week period.•Alzheimer’s dementia patients may not be able to update their self-knowledge.•Our findings fit with philosophical concepts such as sameness and selfhood.•The fact of feeling the same, i.e. sameness, is preserved in Alzheimer’s disease. We looked at whether sense of identity persists in patients with Alzheimer’s disease (AD) and if its profile remains the same between two examinations. A specifically designed protocol was administered to 16 AD patients in the mild to severe stages of dementia and to 16 matched healthy controls, both living in the same institution. We showed that sense of identity was broadly preserved in AD patients. The patterns of their responses were similar to those of controls, and remained consistent over a two-week period. However, some qualitative characteristics of sense of identity in AD patients differed significantly from those of controls, suggesting that AD patients may not be able to update their self-knowledge, probably because of their episodic memory deficit. These results are discussed in the light of both current models of the self and philosophical concepts such as sameness and selfhood.