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How people with dementia and carers understand and react to social functioning changes in mild dementia: a UK-based qualitative study
  1. David Singleton1,
  2. Naaheed Mukadam1,2,
  3. Gill Livingston1,2,
  4. Andrew Sommerlad1,2
  1. 1 Division of Psychiatry, University College London, London, UK
  2. 2 Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
  1. Correspondence to Dr Andrew Sommerlad; a.sommerlad{at}


Objectives To analyse people with dementia and their family carers’ attribution of social changes in dementia and the consequences of these attributions.

Design Qualitative study, using a semi-structured interview guide. Individual interviews continued to theoretical saturation. Two researchers independently analysed interview transcripts.

Setting and participants People with mild dementia and family carers purposively selected from London-based memory services for diverse demographic characteristics to encompass a range of experiences.

Primary and secondary outcomes Attribution of social changes experienced by the person with dementia and the consequences of these attributions.

Results We interviewed nine people with dementia and nine carers, encompassing a range of age, ethnicity and educational backgrounds.

Both groups reported that the person with dementia had changed socially. People with dementia tended to give one or two explanations for social change, but carers usually suggested several. People with dementia were often socially embarrassed or less interested in going out, and they or their relatives’ physical illness or fear of falls led to reduced social activity. Carers often attributed not going out to a choice or premorbid personality. Carers found that their relative needed more support to go out than they could give and carers needed time to themselves because of carer stress or other problems from which they shielded the person with dementia. Additionally, there was decreased opportunity to socialise, as people were bereaved of friends and family. Participants acknowledged the direct impact of dementia symptoms on their ability to socially engage but sometimes decided to give up socialising when they knew they had dementia. There were negative consequences from social changes being attributed to factors such as choice, rather than dementia.

Conclusion Clinicians should ask about social changes in people with dementia. Explaining that these may be due to dementia and considering strategies to overcome them may be beneficial.

  • dementia
  • old age psychiatry

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  • Contributors DS,GL and AS conceived and designed the study. GL and AS obtained ethical approval for the conduct of the study. DS and AS conducted interviews and performed analysis. All authors contributed substantially to drafting the article and revising it critically for intellectual content and gave final approval to the submitted manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or non-profit searches.

  • Competing interests All authors have completed the ICMJE uniform disclosure form at and have nothing to declare.

  • Patient consent All participants gave written informed consent to take part in the study.

  • Ethics approval Ethical approval for this study was granted from Westminster NRES committee (reference: 15/LO/0105).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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