Self-reference effect and autonoetic consciousness in Alzheimer disease: evidence for a persistent affective self in dementia patients.

Episodic memory deficits are predominately the first cognitive impairment in Alzheimer disease (AD). Previous studies have demonstrated that these deficits are specifically linked to autonoetic consciousness impairment, whereas noetic consciousness remains preserved in AD. This study focused on the self-reference effect and examined emotional valence, as it has been shown that emotional content can enhance memory in AD. A task involving recognition of emotional versus neutral adjective traits after self-reference versus semantic encoding, and using the Remember/Know/Guess paradigm was administered to 22 AD patients and 18 normal controls. Results for AD patients show that self-reference increased autonoetic consciousness only for emotional and particularly negative trait adjectives. This interesting result indicates that neutral valence does not allow properties of the self to emerge in AD patients because of the progressive loss of the sense of self-linked to the disease, whereas emotional valence does.