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Familiar Olfactory Stimulation Enhances Self-consciousness in Alzheimer's Disease

María Alejandra Castro Arbeláez¹,², Eva María Arroyo-Anlló¹,², María Leonor Rengifo³, Ivanovna Milqueya de La Cruz⁴

¹ University of Salamanca, ² Institute of Neurosciences of Castilla y León, ³ Universidad de La Sabana, ⁴ Pontificia Universidad Católica Madre y Maestra

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Key Message

Familiar olfactory stimulation significantly enhanced autobiographical episodic memory and multiple dimensions of self-consciousness in individuals with mild-to-moderate Alzheimer's disease, supporting its potential as a person-centered non-pharmacological intervention.

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Background

Alzheimer's disease progressively disrupts autobiographical memory and self-consciousness, compromising personal identity and the continuity of the self. Familiar odors are powerful autobiographical cues capable of eliciting emotionally meaningful memories; however, their potential to enhance self-consciousness remains largely unexplored. Investigating this relationship may contribute to the development of accessible non-pharmacological interventions for dementia care (Addis & Tippett, 2004; El Haj et al., 2015; Glachet et al., 2018).

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Objective

To evaluate the effects of familiar olfactory stimulation on autobiographical episodic memory and self-consciousness in individuals with mild-to-moderate Alzheimer's disease.

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Methods

Study Design: Randomized, Double-blind, Placebo-controlled, Mixed between- and within-subjects design.

Participants: 58 individuals with mild-to-moderate Alzheimer's disease. Experimental group (n=29): Familiar olfactory stimulation. Control group (n=29): Placebo stimulation.

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Results

Table 1. Autobiographical Memory (Pre vs During intervention)

Table 2. Effects of Familiar Olfactory Stimulation on Self-Consciousness (Pre vs Post-intervention)

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Discussion

Familiar olfactory stimulation facilitated access to emotionally meaningful autobiographical memories, reinforcing cognitive processes involved in maintaining self-consciousness. Five of seven SC domains improved significantly in the experimental group: anosognosia, body representation, introspection, moral judgment, and prospective memory, consistent with prior evidence on sensory stimulation and self-awareness (Arroyo-Anlló et al., 2013). Personal identity and affective state remained stable, likely sustained by semantic memory and emotion regulation systems more resistant to brief interventions (El Haj et al., 2019; Gil et al., 2001). These findings suggest that olfactory cues may contribute to preserving the sense of self in AD.

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Conclusions

Familiar olfactory stimulation evoking specific, fluent, and emotionally rich autobiographical memories enhanced key dimensions of self-consciousness in mild-to-moderate AD, particularly anosognosia, moral judgment, introspection, and body representation. These findings support the development of low-cost, person-centered non-pharmacological interventions for dementia care.

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References

Addis, D., & Tippett, L. J. (2004). Memory, 12, 56–74.
Arroyo-Anlló, E. M., Poveda Díaz, R., & Gil, R. (2013). BioMed Research International, 2013, 752965.
El Haj, M., Antoine, P., Nandrino, J. L., & Kapogiannis, D. (2015). Ageing Research Reviews, 23, 183–192.
Glachet, O., Gandolphe, M. C., Gallouj, K., Antoine, P., & El Haj, M. (2018). Gériatrie et Psychologie Neuropsychiatrie du Vieillissement, 16, 311–320.
Gil, R., Arroyo-Anlló, E. M., Ingrand, P., Gil, M., & Neau, J. P. (2001). Self-Consciousness Questionnaire.
Piolino, P., Desgranges, B., & Eustache, F. (2000). TEMPau.
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