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.
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DOI：
10.3233/jad-200407
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Tippett LJ
中科院分区：
文献类型：
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作者：
Clare L;Martyr A;Morris RG;Tippett LJ
痴呆的发生和发展会导致自我主观体验的变化，影响心理健康。我们的目的是探索轻度至中度痴呆症患者在自我主观体验中经历不连续性的程度，以及痴呆症患者及其家庭照顾者与这种体验相关的因素。我们使用的数据来自IDEAL队列的基线评估。通过询问参与者对“我觉得我一直是同一个人”这一陈述的同意程度，评估了自我主观体验的不连续性。参与者被分为那些谁没有经历中断，并在人口统计学和疾病相关的特征，心理健康，“生活幸福”的措施，和照顾者的压力方面对这两组进行了比较。对连续性问题的回答可用于1，465名痴呆症参与者，其中312人（21%）报告经历了不连续性。中断组经历了显着较差的心理健康，并有显着较低的分数在“生活幸福”的措施。与人口统计学或疾病相关特征没有明确的联系，但有一些迹象表明照顾者压力增加。相当一部分轻度至中度痴呆症患者描述了自我主观感觉的不连续性，这与心理健康状况较差和“生活良好”的能力降低有关。敏感地询问痴呆症患者关于自我的主观体验可能提供一种简单的方法来识别那些处于不良健康风险增加的人。
The onset and progression of dementia can result in changes in the subjective experience of self, impacting on psychological health. 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. 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. 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. 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.