Psychological Processes in Adapting to Dementia: Illness Representations Among the IDEAL Cohort

Linda Clare*, Laura D. Gamble, Anthony Martyr, Catherine Quinn, Rachael Litherland, Robin G. Morris, Ian R. Jones, Fiona E. Matthews

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


How people understand and adapt to living with dementia may influence well-being. Leventhal’s Common Sense Model (CSM) of Self-Regulation provides a theoretical basis for exploring this process. We used crosssectional and longitudinal data from 1,109 people with mild-to-moderate dementia in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort. Weelicited dementia representations (DRs) using the Representations and Adjustment to Dementia Index (RADIX), a validated measure based on the CSM, identified groups sharing distinct DR profiles, and explored predictors of group membership and associations with well-being, and whether problem-focused coping played a mediating role in these associations. We identified four DR classes: people who see the condition as a disease and adopt a diagnostic label; people who see the condition as a disease but refer to symptoms rather than a diagnostic label; those who see the condition as part of aging; and those who are unsure how to make sense of the condition. A fifth group did not acknowledge any difficulties. “Disease” representations were associated with better cognition and younger age, while “aging” and “no problem” representations were associated with better mood and well-being. The association with well-being remained stable over 24 months. There was limited partial support for a mediating role of problemfocused coping. Variations in DRs may reflect individual differences in the psychological processes involved in adjusting to dementia. DRs provide a framework for personalizing and tailoring both communications about dementia and interventions aimed at supporting people in copingwith dementia. There is a need to debate hat constitutes a positive DR and how its development might be encouraged.

Original languageEnglish
JournalPsychology and Aging
Publication statusAccepted/In press - 2021


  • Alzheimer’s disease
  • Coping
  • Dementia representations
  • Quality of life
  • Well being


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