Riassunto analitico
The role of rumination and reflection in mental and physical health has garnered significant attention in recent years. Rumination is known as a factor contributing to various negative health outcomes, whereas self-reflection is associated with enhanced subjective and psychological well-being. However, the relationship between these constructs and neurodegenerative diseases, particularly Alzheimer's Disease (AD), remains underexplored.
This study aims to investigate the neuropsychological and brain mechanisms underlying rumination and reflection in patients with AD. We hypothesize that these mechanisms may act as protective or predisposing factors, influencing brain resilience or vulnerability to the development of specific symptoms in AD-affected individuals.
We recruited 25 healthy controls and 35 AD patients from the Modena Cognitive Neurology Clinic, Italy, between 2022 and 2024. Participants underwent comprehensive neuropsychological assessments and MRI scans.
Behavioral analyses revealed significant differences between AD patients and healthy controls in demographic characteristics and cognitive performance. Among premorbid personality traits, there was a positive correlation between past tendency to reflection and both premorbid openness and agreeableness, and between past tendency to rumination and premorbid conscientiousness. High reflection scores were related also to functional-executive functions, awareness for cognitive deficit (i.e., Anosognosia Dementia Questionnaire discrepancy score), preserved independence in instrumental daily activities, and cognitive reserve acquired during leisure time. Past levels of rumination had instead a relationship with cognitive reserve acquired during working activity and with levels of cerebrospinal fluid phosphorylated-tau. Imaging analyses focused on the correlation between the level of rumination and reflection based on the Rumination-Reflection Questionnaire and grey matter volume.
Our results indicate that rumination and reflection have distinct neuropsychological correlates in AD patients compared to healthy controls. These findings suggest potential pathways through which premorbid personality traits such as a tendency to rumination and reflection may influence the development of specific symptoms in patients with AD. This study contributes to understanding cognitive and neural processes in AD, with potential implications for understanding brain resilience and vulnerability in neurodegenerative diseases.
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