Interest of a mental representation approach to the disclosure of Alzheimer's disease diagnosis

This paper explores the mental representation of Alzheimer disease ( AD) by assessing the number of words given by the subjects when asked to quickly write seven words characterizing AD in three groups of subjects: 22 caregivers, 22 professional informants, and 28 naive subjects. The generated words were classified into six dimensions: memory, other neuropsychological impairments, behavioral disorders, consequences on caregiver relationships, familial and social changes, and health. AD mental representation was clearly negative in the three groups and did not differ between groups. Memory was the most frequent dimension reported in all groups with 78 quoted words (20.1% of responses). However the hierarchical classification of the dimensions differed in the three groups. The caregivers reported more words related to social and familial changes. Social and familial modifications, and behavioral changes were first reported by the professionals. The naive subjects firstly quoted words concerning memory and others neuropsychological deficits. However, naive subjects who had previously be in contact with AD patients mainly reported words about behavior changes. Actually, naive subjects are not fully naive because the clinical aspects of the disease are currently well known in the general population. Families and professional informants reported that AD familial and social changes had a deeper impact than cognitive or behavioral aspects. This preliminary study suggests that AD mental representation is the same in the general population, but the weight of the different dimensions affecting AD differed between subjects concerned or not by the disease (family or professional versus naive subjects). Therefore, the weight of the different dimensions is to be taken into account for a better approach of the disclosure of AD diagnosis.