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Mental representations of daily activities throughout the course of dementia
Author(s) -
Ross Sabrina D.,
Rodriguez Francisca S.
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.039076
Subject(s) - dementia , psychology , cognition , activities of daily living , developmental psychology , mental health , clinical psychology , gerontology , psychiatry , disease , medicine , pathology
Background Since dementia is a result of cognitive rather than physical impairment, cognitive functioning should also be considered when estimating the care of older people. This study investigated how the loss of cognitive functioning affects mental representations of daily activities and their performance throughout the course of dementia. A mixed‐model study was conducted to investigate how the content of the mental representations differs between stages of dementia. Method In order to gain a better insight into how changes of mental representations of daily activities get affected throughout the disease of dementia, we conducted the script generation task of daily activities (grocery shopping, doing laundry, going to the dentists) and the Montreal Cognitive Assessment (MoCa), from 25 people (age (mean: 67.64; SD: 23.625), sex (f: 14 (56%); m: 17 (68%)), cognitive status (healthy: n=6; mild demented: n=7; severe demented: n=12)) as well as a qualitative semi‐structured interview. In this mixed‐method design, the qualitative analysis was based on the Grounded Theory . Result Overall, we found evidence that mental representations of daily activities loose in content and get inaccurate throughout the course of the disease, whereas not always a steady transition according to the assessed cognitive status was observed. However, mental representations on performing daily activities remained correct throughout the course of dementia, even though the ability to perform those activities decreased. We further observed a great variance in the content generated by severe demented people ranging from a complete reduction of actions to expansive script action generation. It was also shown that, in early stages of dementia, mental representations of daily activities are disrupted, which is predominantly shown in an incipient increase in sequencing errors and, in the further course of the disease, an increase in intrusions and personalizations. Conclusion This study outlines how dementia affects mental representations and performance of daily activities throughout dementia. It turns out that script generation is hampered by decreasing cognitive functioning, the content of the generated actions for mental representations of daily activities reflect functional impairment. Further research is needed to gain a detailed understanding in how script generation gets affected along decreasing cognitive status.