Self in Dementia

Episodic autobiographical memory is a component of different models of self. Since it is impaired in the early stages of Alzheimer’s disease, patients are likely to experience impaired autobiographical self (“I lost myself”). Moreover, patients are not always aware of their memory impairment, and reduced awareness of self likely depends on a combined dysfunction of memory and executive processes. The precise executive dysfunctions leading to impaired self-reflection in Alzheimer’s disease remain to be specified. Accordingly, the neuroimaging literature suggests that different executive dysfunctions are involved in self-unawareness. However, even in severe stages of the disease, abstract summaries (such as “I am a baritone”) kept in personal semantic memory (a conceptual self) may allow patients to maintain a “core” self with a sense of personal identity. Therefore, the study of the patient’s subjective experience of self, memory, and executive functions may play an important role in the further understanding and clinical treatment of Alzheimer’s disease.