Journal of Dementia
Open Access

Dementia; Strikwerda-Brown; Psychological symptoms; Chronic diseases; Hyper-phosphorylation

Introduction

Worldwide, dementia affects over 46 million people, and this number is expected to triple by 2050. Although different kinds of dementia have different symptoms, one thing they all have in common is a significant impact on cognition, especially the gradual loss of memory [1]. Dementia’s underlying causes are also acknowledged to be behavioral and psychological shifts. Changes in one’s sense of self have been identified as one of the most distressing psychological symptoms of dementia for both those living with the disease and those who care for them. Approaching a day to day existence story is viewed as key to the human experience of selfhood. Since self and memory are inextricably linked, it has been hypothesized that individuals with dementia may experience a “weakening” of selfhood due to gaps in autobiographical self-knowledge and fragmented episodic memories [2]. However, self-related memory is just one manifestation of the self, which is a complex construct with numerous manifestations. According to Ross, Anderson, Campbell, & Collins, the human experience of “selfhood” can be conceived of here as the knowledge of having a distinct identity and intentional physical presence in the world, accompanied by a strong sense of continuity over time [3].

Method

Terms like “total loss,” “impairment,” and “erosion” of selfhood have historically been used in the literature to describe the pronounced changes in the self-experience of people with dementia, implying the existence of a unitary construct of self when examining the impact of dementia on self. According to Hillman & Latimer, such descriptions can encourage perceptions of complete self-destruction, escalating the stigma and fear associated with a dementia diagnosis [4]. According to Strikwerda-Brown, Grilli, Andrews-Hanna, & Irish, modern opinions caution against viewing the self as a “monolithic entity” because this conceptualization may be oversimplified and fails to capture the real effects of dementia on the sense of self. The current scoping review aims to investigate the nature and scope of the evidence demonstrating change in multiple aspects of the psychological self in people living with dementia, recognizing the multidimensional nature of the self [5].

According to Tolhurst, Bhattacharyya, and Kingston, the inherent difficulty of a precise definition of the self has contributed to potential misinterpretations regarding changes to the sense of self in people with dementia, despite the fact that self-related functions have been extensively studied in the dementia literature. According to Klein & Gangi , even though we have a single sense of who we are, the self can be thought of as a collection of related but distinct aspects from which unity emerges [6]. According to Bomilcar, Bertrand, Morris, & Mograbi, it has been proposed that the various manifestations of the self-have a hierarchical relationship, with self-processes that develop earlier serving as the foundation for the emergence of higher-order processes. Summa Higher-order manifestations of the psychological self could be characterized as self-related functions linked to sophisticated cognitive processes; These include self-knowledge, a sense of having a life narrative, and autobiographical memory Mograbi, Huntley, and Critchley However, there are other aspects of the self that may not always be accessible for conscious reflection; This is especially evident in processes like agency and embodiment, which could be the fundamental manifestations of the self that are based on the awareness that one’s body is their own and have an impact on the physical and social worlds [7].

Result

Although it is theoretically reasonable to distinguish between foundational and high-order self-manifestations, this distinction may not be clear-cut; A cross-connections network is created by the dynamic interaction of various levels with one another. Summa refers to these as the “grey zones” that lie in between the two kinds of manifestations.

According to Cunningham & Turk, the self plays a crucial functional role in human cognition, supporting a number of cognitive processing biases that are automatic, occur without conscious awareness, and involve the cognitive organization of self-related information [8]. For instance, humans prioritize self-related information, which is elaborated and organized within existing semantic and autobiographical selfknowledge and helps to maintain the self-system. These processes, which unite high-order manifestations of self-knowledge with fundamental aspects of selfhood like the agentive experience of an event, could be referred to as operating in the “grey zone.” Functional aspects of the self might link the high-order and foundational manifestations together, allowing for bidirectional interactions, if one considers the various manifestations to exist along a continuum [9].

The presence of various parts of the mental self-shows that dementia’s effect on selfhood is probably not going to be outright. According to Caddell and Clare, the most recent systematic review of the psychological self in dementia, self and identity are mostly preserved, at least to some degree, throughout the course of dementia, with qualitative aspects of the subjective experience of self-remaining undisturbed. According to Weiler, Northoff, Damasceno, & Balthazar, despite the fact that some aspects of the self-remain intact in dementia, self-manifestations involving complex high-order processes are susceptible to negative effects [10]. The evidence supporting this conclusion has increased ever since Caddell and Clare reviewed the research. For instance, it is well known that people with dementia experience diminished self-awareness as a result of their episodic memory loss; as self-recollections blur and self-information on one’s life account breaks down, admittance to self-related personal data is compromised prompting modifications of seen identity.

Discussi on

According to additional findings individuals with dementia may be unable to update information about their current self and must rely on previous self-representations, which means that self-knowledge and, consequently, self-continuity may become out of date, frequently reflecting young adulthood. Together, it has been hypothesized that only memory-related aspects of the self may be affected by dementia, while foundational aspects of the self, such as self-related experiences of living in the present, may be preserved. Overall, the experience of fragmented selfhood is caused by a change in one’s sense of self, which is undoubtedly a significant psychological symptom of dementia.

Emanant proof appears to arrive at arrangement concerning the intricacy and multi-faceted nature of the mental self, showing that its various viewpoints probably won’t be similarly affected by dementia.

Conclusion

However, the existing empirical research on the effect of dementia on selfhood consists of a variety of studies using a variety of approaches and frequently focusing on individual psychological selfmanifestations. Recognizing the multidimensional nature of the self is necessary for achieving a more comprehensive comprehension of the effects of dementia on the psychological self. Although it provides a useful framework for bridging this diversity (spanning foundational, functional, and high-order self-processes), it has not been widely utilized. As a result, despite responding to Caddell and Clare’s (2010) call for more research into how dementia affects the psychological self, this research has not been systematically reviewed and analyzed within a single framework.

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