Metacognitive Rehabilitation in the Elderly: the Mind the Gap Metacognitive Program

Abstract

This paper introduces the Mind the Gap Metacognitive Program (MGM-P), an innovative rehabilitation approach to contrast and prevent anosognosia. Anosognosia, or impaired self-awareness of illness and related deficits, is a pretty frequent phenomenon in Alzheimer's Disease, even in pre-clinical stages, which may have detrimental effects on clinical course, therapy compliance, risky behaviors, not to say caregivers’ stress and burden. Stemming from a complex bio-psycho-social perspective and firmly rooted in accredited neuropsychological models on self-awareness and metacognition, the MGM-P aims at improving patients’ realistic self-appraisal, facilitating the adoption of self-safety behaviors and compensatory strategies, thus lessening patients’ and caregivers’ stress. Theoretical models, structure of sessions, and methodology are illustrated. The MGM-P can be administered to the Elderly with dementia but also with Mild Cognitive Impairment and Subjective Cognitive Complaint. Thus, the MGM-P has been developed as a therapeutic approach and as a preventive tool to buffer cognitive decline and facilitate identifying elderly at-risk subjects. Another original aspect of MGM-P is the presence of quantitative indices, which allow the clinician to objectively rate the patient’s progress in different metacognitive functions and make the MGM-P quite adaptable for research purposes. Last but not least, MGM-P shows a wide range of fruitful next ameliorants and applications in other neuropsychiatric conditions and different contexts, such as in educational and job formation fields.