Open AccessPsychological processes in adapting to dementia: Illness representations among the IDEAL cohort.
Author(s) -
Linda Clare,
Laura D. Gamble,
Anthony Martyr,
Catherine Quinn,
Rachael Litherland,
Robin G. Morris,
Ian Rees Jones,
Fiona E. Matthews
Publication year - 2022
Publication title -
psychology and aging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.468
H-Index - 151
eISSN - 1939-1498
pISSN - 0882-7974
DOI - 10.1037/pag0000650
Subject(s) - dementia , psychology , mood , cohort , coping (psychology) , disease , cognition , psychological intervention , clinical psychology , developmental psychology , psychiatry , medicine , pathology
How people understand and adapt to living with dementia may influence well-being. Leventhal's Common Sense Model (CSM) of Self-Regulation provides a theoretical basis for exploring this process. We used cross-sectional and longitudinal data from 1,109 people with mild-to-moderate dementia in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort. We elicited dementia representations (DRs) using the Representations and Adjustment to Dementia Index (RADIX), a validated measure based on the CSM, identified groups sharing distinct DR profiles, and explored predictors of group membership and associations with well-being, and whether problem-focused coping played a mediating role in these associations. We identified four DR classes: people who see the condition as a disease and adopt a diagnostic label; people who see the condition as a disease but refer to symptoms rather than a diagnostic label; those who see the condition as part of aging; and those who are unsure how to make sense of the condition. A fifth group did not acknowledge any difficulties. "Disease" representations were associated with better cognition and younger age, while "aging" and "no problem" representations were associated with better mood and well-being. The association with well-being remained stable over 24 months. There was limited partial support for a mediating role of problem-focused coping. Variations in DRs may reflect individual differences in the psychological processes involved in adjusting to dementia. DRs provide a framework for personalizing and tailoring both communications about dementia and interventions aimed at supporting people in coping with dementia. There is a need to debate what constitutes a positive DR and how its development might be encouraged. (PsycInfo Database Record (c) 2022 APA, all rights reserved).