Abstract
ObjectiveTo study the emotional state of cognitively impaired patients through the color choice preference in a group of Alzheimer’s disease (AD) patients and compare it with a group of Mild Cognitive Impairment (MCI) patients and a matched control group.MethodsA total of 71 AD, 50 MCI and 68 controls were consecutively evaluated. All patients and controls underwent the Mini Mental State Evaluation (MMSE) and the Lüscher color test.ResultsCognitively impaired patients mainly chose auxiliary colors, in particular violet and brown, and rejected black and gray. AD patients predominantly chose forms corresponding to auxiliary colors. The auxiliary color choice negatively correlated with the MMSE score. MCI patients and controls had a higher presence of anxiety on gray table and controls had higher frustration and ambivalence, i.e., psychic complexity, on basic color tables.Data globally suggest that AD patients live with a feeling of personal change due to instability and emotional insecurity, experiencing physical discomfort and a bodily need of being welcomed in a favorable environment. They aspire to a sensitive understanding by someone with whom they can be identified. Differently, MCI patients have less of these needs; however, they feel more anxious.ConclusionThe comprehension of the inner emotional state of cognitively impaired patients allows us to better communicate with them and effectively approach their behavioral disorders. Like other projective techniques, such as the tree-drawing test and the human figure-drawing test, Lüscher color test is proposed as a simple and unconventional approach to understand the emotional life of AD patients. The awareness of clinicians about the existential fragility and insecurity of such type of patients allows us not only to better manage their behavioral disturbances but also to improve their quality of life and that of their caregivers.
Highlights
Alzheimer’s disease (AD) is a neurodegenerative disorder, primarily affecting memory and attention, that leads to a progressive global cognitive dysfunction
71 AD and 50 mild cognitive impairment (MCI), referred for cognitive disorders over a 1-year period by their relatives and physicians or who spontaneously presented themselves to the Cognitive Disorders Center of IRCCS Istituto delle Scienze Neurologiche of Bologna, Italy
Patient inclusion criteria were as follows: (a) major or minor neurocognitive disorder according to DSM-V criteria (American Psychiatric Association, 2013); (b) diagnosis of AD and MCI based on the international criteria (Petersen et al, 2009; McKhann et al, 2011)
Summary
Alzheimer’s disease (AD) is a neurodegenerative disorder, primarily affecting memory and attention, that leads to a progressive global cognitive dysfunction. It is the main cause of dementia accounting for 50–75% and doubling in prevalence every 5 years after age 65 (Lane et al, 2018). In our Cognitive Disorders Center the rate of conversion is 18.4% in a 4-year follow-up (Gallassi et al, 2010) while in literature higher annual rates of progression are reported (6–15%) (Petersen et al, 2009). MCI and AD represent a continuum from the mildest degree of cognitive impairment to dementia
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