Envisioning the self: self-defining future projections in Alzheimer’s disease

Geriatr Nurs. 2026 Sep 5;74(Pt A):104344. doi: 10.1016/j.gerinurse.2026.104344. Online ahead of print.

ABSTRACT

Self-defining future projections (SDFPs) are vivid, emotionally salient projections of personally meaningful events that anchor identity and guide motivation. While past self-defining memories ground the self in remembered experiences, SDFPs extend this function into the future, offering a forward-looking perspective on identity and well-being. In Alzheimer’s disease (AD), cognitive decline threatens autonomy, memory, and self-continuity, yet little is known about how SDFPs are affected. The present study examined SDFPs in 37 individuals with mild AD and 40 cognitively healthy older adults. Participants generated SDFPs, which were evaluated for specificity, integrative meaning, importance, and emotional valence. Compared to controls, patients with AD produced less specific, less integrated, and less important future events, while emotional intensity remained comparable across groups. In AD patients, better cognitive functioning predicted greater specificity, whereas higher depression and anxiety were associated with reduced specificity, integration, and importance, as well as higher negative emotions. These findings highlight that AD compromises the structural and identity-related features of future self-projections, but preserves emotional engagement, suggesting a potential pathway for interventions to support motivation, self-continuity, and well-being.

PMID:42700507 | DOI:10.1016/j.gerinurse.2026.104344