Self-Concept in Mild Cognitive Impairment and Mild Dementia due to Alzheimer's Disease Is Affected on Tests of Self-Generated Statements

Several studies show that Alzheimer's disease (AD) and other neurocognitive disorders have a negative impact on the self and identity formation. Most studies have included persons with mild to moderate dementia, but how AD patients in the earliest phases retrieve information about themselves has only been studied scarcely. The aim of this study was to investigate if persons with mild cognitive impairment (MCI) and mild AD would generate fewer self-related statements than healthy controls. From a memory clinic, we included 17 aMCI patients, 17 patients with mild dementia (AD; MMSE ≥ 24), and 30 healthy controls. Three Events Test and Twenty Statements Test (TST) were applied to all participants. The persons with mild dementia gave significantly fewer statements compared to the controls (p < 0.001) and the aMCI patients (p < 0.01) on TST. Fewer statements were also produced by the aMCI patients compared to the control participants (p < 0.05). Persons from both patient groups produced significantly fewer contextual details compared to the controls on the Three Events Tests. There were significant associations to lexical fluency for both the TST and Three Events Test, but only a limited amount of variance was explained, and the results cannot be explained solely by a fluency effect. The results from this study are in accordance with findings from previous studies demonstrating that mild AD leads to a decline in both autobiographical memories and a diminished sense of self. Further, this study shows that changes in self-concept may occur even in the earliest clinical stages of AD.