The social construction of dementia: Systematic review and metacognitive model of enculturation.

BACKGROUND: The stigma associated with dementia may be influenced by how the condition has been socially constructed throughout history.

OBJECTIVES: To conduct a systematic review tracing the historical representations of dementia, from the perspectives of cultural transmission theory and social constructivism.

METHODS: A systematic search was run on five electronic databases: Wellcome Library, PsycINFO, CINAHL, IBSS, and EMBASE. Articles were screened and analysed through deductive content analysis. We further applied a communication system theory to graphically describe how dementia has been experienced through time.

RESULTS: Ten primary sources and 33 secondary sources were consulted. Seven themes emerged from the analysis: a problem of aging; use it or lose it; divine punishment; loss of agency; psychosis and insanity; brain degeneration and objectification; and dementia as a social condition. Each theme corresponds to a particular way of conceptualising dementia and has influenced modern representations of the condition.

CONCLUSION: Past characterisations of dementia have influenced modern views of the condition. It is through enculturation that these views are interpreted, assimilated, or rejected by individuals and transmitted within and across cultures. A better understanding of the social construction of dementia can improve public health approaches to rehabilitation and care.