Understanding Alzheimer's disease as a disorder of consciousness.

People with Alzheimer's disease show a range of changes in consciousness, including reduced awareness of cognitive deficits, diminished self-awareness, and impaired introspection, which appear early and worsen as the disease progresses. These awareness impairments are linked to brain damage in areas that overlap with proposed neural correlates of consciousness. The authors argue that recognizing Alzheimer's disease as a disorder of consciousness is overdue and important for understanding patients' lived experience and improving care.

Study at a glance

Abstract

People with Alzheimer's disease (AD) demonstrate a range of alterations in consciousness. Changes in awareness of cognitive deficit, self-awareness, and introspection are seen early in AD, and dysfunction of awareness and arousal progresses with increasing disease severity. However, heterogeneity of deficits between individuals and a lack of empirical studies in people with severe dementia highlight the importance of identifying and applying biomarkers of awareness in AD. Impairments of awareness in AD are associated with neuropathology in regions that overlap with proposed neural correlates of consciousness. Recent developments in consciousness science provide theoretical frameworks and experimental approaches to help further understand the conscious experience of people with AD. Recognition of AD as a disorder of consciousness is overdue, and important to both understand the lived experience of people with AD and to improve care.