The impact of dementia on self and identity: a systematic review

There is much debate in the literature as to the extent to which self and identity persist in people with dementia. The aim of this systematic review was to examine methods currently used to investigate self and identity in people with dementia, and the resulting evidence as to the persistence of self and identity throughout the course of the disease. Thirty-three studies were reviewed, which showed that many approaches have been taken to studying aspects of self and identity in dementia, including both quantitative and qualitative methods. This appears to be partly due to the differing underlying concepts of self that have been used as a basis for these studies. Consequently, results obtained from these studies are somewhat disparate, although it is possible to draw some tentative conclusions from the available evidence. Almost all of the studies suggest that there is at least some evidence for persistence of self in both the mild and moderate to severe stages of the illness, although many studies record some degree of deterioration in aspects of self or identity. Further research is required to clarify existing evidence and to address outstanding questions regarding self and identity in dementia.