Attitudes towards Personhood in the Locked-in Syndrome: from Third- to First- Person Perspective and to Interpersonal Significance

The relationship between perceived stigma and perceived stress in cognitive decline: a survey of persons with mild cognitive impairment and their caregivers

Introduction

While Alzheimer's disease and other causes of dementia have rapidly become a global health crisis with growing incidence that is unabated, the incidence of Mild Cognitive Impairment (MCI) far exceeds that of Alzheimer's disease. Persons with MCI demonstrate some level of cognitive impairment, but daily functions remain intact and there is no certainty that they will develop dementia. Yet, the possibility conjures a considerable amount of fear and anxiety, further fueled by a vast array of misconceptions and stigma. The pervasive nature of this stigma permeates society and culture at many levels. Persons with MCI who are at higher risk for development of dementia may be especially vulnerable to fear and stigma associated with the diagnosis. Based on this premise, the primary aim of this study was to examine the relationship between perceived stigma and perceived stress in persons with MCI and their care partners, including the relationship between income and the study variables. The secondary aim was to examine the effect of a combined cognitive rehabilitation and wellness program on these perceptions.

Methods

Thirty participants were recruited from Mayo Clinic's Health Action to Benefit Independence and Thinking (HABIT) program. MCI (n = 15) and care partner (n = 15) participants completed the Stigma Impact Scale (SIS) and the Perceived Stress Scale (PSS) before and after the HABIT program.

Results

Average SIS and PSS scores decreased in the MCI, care partner, and combined groups, both pre- and post-HABIT. Linear regression was used to assess the relationship between perceived stigma and stress, controlling for income. A significant relationship was found between perceived stigma and perceived stress both pre and post-HABIT.

Discussion

The results suggest a relationship exists between perceived stigma and perceived stress in persons with MCI and their care partners, and an educational program such as HABIT may strengthen this relationship by informing participants of potential challenges that occur in cognitive decline. Understanding these relationships may provide an opportunity to provide tools for this vulnerable population.

Neuroscience of consciousness in the locked-in syndrome: Prognostic and diagnostic review

The neurological illness known as a locked-in syndrome is brought on by damage to the brainstem, usually as a consequence of a stroke. It is characterized by total paralysis with intact consciousness and cognitive capacity. The subjective experiences of people with locked-in syndrome are poorly understood. Presently, there is no systematic evaluation developed to describe them. The most compelling resources come from individuals' own words; however, only a small fraction of these accounts have been explored. When it comes to bioethics, locked-in syndrome protocols are almost completely absent. Investigations on how people with this condition feel about their sense of continuity are of importance. Utilizing the locked-in syndrome to pose questions on embodied cognition and levels of consciousness could serve as a lens through which to examine problems in the phenomenology of neuroparalysis and communication. Care and quality of patients' lives might be improved by an effort to understand this condition better, and ontological questions like "what makes a person a person?," "what makes a person appear in continuity?," and "what are the dynamics of embodiment and intersubjectivity?" might be better explored through that lens. This article aims to explore some biomedical factors that contribute to locked-in syndrome and offers some prognostic and diagnostic recommendations for this rare condition.