The subjective perception of past, present, and future time in patients with Alzheimer’s disease: a qualitative study

Figures & data

Table 1 The subjects profile

Subjects	Age	Sex	MoCA	Years of AD	Comorbidities	Barthel index
1	80	Male	24	2	DM	100
2	86	Female	15	2	COPD	90
3	79	Female	21	3	DM	100
4	84	Male	18	5	HT, DL	100
5	69	Female	16	2	n.p.	100
6	84	Male	17	2	Af, HT, DL	100
7	85	Male	21	2	HT, DL	100
8	80	Male	22	1	n.p.	100
9	82	Female	16	5	HT	100
10	82	Male	21	3	IP	100
11	86	Male	13	4	n.p.	100

Abbreviations: AD, Alzheimer’s disease; DM, diabetes mellitus; HT, hypertension; DL, dyslipidemia; Af, atrial fibrillation; IP, interstitial pneumonia; MoCA, Montreal Cognitive Assessment; n.p., nothing particular.

Figure 1 A model of subjective time in normal individuals.

Note: Time flows from the past to the present to the future.

Figure 2 A model of subjective time in AD patients.

Notes: The subject alternates between awareness of the past and present and has difficulty imagining the passage of time to the future. The end (death) is imagined immediately after the future, giving the future a definite end.
Abbreviation: AD, Alzheimer’s disease.

Table 2 Frequency of each category observed during individual subject interviews

Category	Code	1	2	3	4	5	6	7	8	9	10	11
Live according to a private clock	Unstable estimates of the passage of time	○	○		○	○	○		○
	Everything around me is changing	○	○				○			○
	Live according to a private clock							○	○		○	○
Go back and forth between the past and present	Go back and forth between the past and present	○	○					○	○
The past comes up	The past comes to mind vividly	○	○	○	○	○	○	○	○	○	○	○
	I am reminded of the past and feel close to it	○		○		○		○	○			○
Bid farewell to this world as early as tomorrow	Bid farewell to this world as early as tomorrow		○			○	○	○	○	○		○
Cannot imagine the future	Cannot imagine a future image of myself	○	○	○	○	○	○		○			○
	Future image without justification	○	○		○	○		○			○

Table

Subject	Interview data	Code
7	I live my life in view only of myself. Because this way of life suits me, I do not really feel it slow or fast.	Live according to a private clock
7	Well, I am alone, and I live my life according to my own private clock. So there is no concept of time shortage or the like.	Live according to a private clock
11	Now I live in whatever way I want to.	Live according to a private clock
1	Well, you know … it just feels normal. ((Oh, it does.)) Yes … slow, slow and quick?	The present wavering to and fro
5	It feels just right or … ((Yes?)) it feels quick.	The present wavering to and fro
1	((When do you feel that one year is short?)) Well, because my grandchildren are getting bigger and bigger (with laughter).	Observe time passing
2	Because you know. Well, the go broadcast in NHK. Since the last time. It’s on the air every week. ((Yes.)) It’s been, well, excuse me, one month … since, no … one week. One week has already passed. In that sense, I feel it is moving fast.	Observe time passing
6	Oh, it’s already noon, it’s already evening.	Observe time passing

Table

5	Sometimes, it comes back to me … gradually in this manner … as if it … it were a story.	The past comes up
11	The memory just … bursts on my memory vividly.	The past comes up
1	It seems I’ve been reminded of it for quite some time. So it might be closer.	Remember with intimacy
3	((So you feel fairly close to it.)) Yes … yeah. I clearly remember it. Most of it.	Remember with intimacy

Table

2	Well, I cannot say it is close, but it is not so distant either … because, even now, I would love to go if I had a chance to.	Go back and forth between the past and the present
7	You see. Well … my home has not changed. Naturally, many things also … well, my neighbors also have not changed. At every turn of events, the memory flashes across my mind.	Go back and forth between the past and the present

Table

3	The future is … ((Yes?)) I am not sure.	Cannot imagine the future
4	That is something unpredictable. Yeah.	Cannot imagine the future
6	Future? I have no future (laughter).	Cannot imagine the future
11	Hmm, I don’t think too deep … about … how many years ahead. No I am laid back.	Cannot imagine the future
1	Hmm. Well, about 5 years from now.	No justification for the future
2	Well, oh boy. Okay. Well, I would be happy if I die in, say, 5 years.	No justification for the future
4	Even now, though I don’t have medical justification, I am very pessimistic now.	No justification for the future
10	Well, how many years … maybe 10 years ahead.	No justification for the future

Table

2	I don’t feel it too distant. It’s close, maybe fairly close. It seems.	Bid farewell to this world as early as tomorrow
3	Thought about future … it is right before death, slightly before death.	Bid farewell to this world as early as tomorrow
5	I’ve thought about bidding farewell to this world as early as tomorrow.	Bid farewell to this world as early as tomorrow
6	It is close. But you will never know this, yeah?	Bid farewell to this world as early as tomorrow
7	I have little time left. Little time left to live.	Bid farewell to this world as early as tomorrow
9	Moving forward! ((Yes, future.)) You know. I am short-lived (laughter).	Bid farewell to this world as early as tomorrow