Patient Perspectives about Mild Cognitive Impairment: A Systematic Review

Blatchford, Lisa; Cook, Jennifer

doi:10.1080/07317115.2020.1805536

Cited by 14 publications

(5 citation statements)

References 61 publications

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“…More specifically, evidence suggests that prior personal experience of dementia in family or friends and perceived health status of an individual influences the way they interpret and cope with the MCI diagnosis. 12 In our cohort, in contrast to FwMCI, the majority of PwMCI had no previous experience of a person with memory problems. This may explain the discordance in the perception of MCI between the two groups.…”

Section: Discussionmentioning

confidence: 68%

“…Existing evidence suggests that patients' and carers' understanding of MCI is influenced by clinicians' understanding and communication of the construct and quality of information provided. 12 Clinicians have varying perspectives about the utility of the 'mild cognitive impairment' diagnosis. This influences their discussion of the results of the assessment and the advice given.…”

Section: Discussionmentioning

confidence: 99%

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Psychosocial impact of being diagnosed with mild cognitive impairment: patient and carer perspective

Munawar,

Kennedy,

Usman

et al. 2023

BJPsych open

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Background Mild cognitive impairment (MCI) may represent an intermediate, prodromal phase of dementia. Although persons with MCI (PwMCI) are able to function independently, they often experience reduced ability to carry out their usual activities. This can result in social, emotional and functional challenges. Aims To explore the understanding and psychosocial impact of receiving a diagnosis of MCI on patients and carers. Method A cross-sectional cohort study was conducted at St James's Hospital Memory Clinic involving patients who attended the clinic for assessment from 1 January 2020 to 30 April 2021 and received a diagnosis of MCI. We completed questionnaires with patients and a nominated family member or friend of each patient (FwMCI). Results Forty-seven PwMCI participated in the study, and 36 nominated family members and/or friends completed the FwMCI questionnaire. In our cohort of PwMCI, most of the participants were not aware of their diagnosis; only 21% used the term MCI, and only 25% attributed their problems to a pathological cause. The majority of participants had no recollection of any discussion around the likelihood of progression. One-third of participants expressed relief that they did not have dementia. Most PwMCI reported positive psychological well-being and did not endorse symptoms of depression or anxiety. There was slight discordance of illness perception among the PwMCI–FwMCI dyads. Forty-seven per cent of FwMCI reported at least a mild degree of carer burden on the Zarit Burden Scale. Conclusions Patients’ awareness of being diagnosed with MCI is relatively limited. Public education campaigns raising awareness about MCI can help influence the ‘illness representation’ for MCI and enable people to seek timely advice and support.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Psychosocial impact of being diagnosed with mild cognitive impairment: patient and carer perspective

Munawar,

Kennedy,

Usman

et al. 2023

BJPsych open

View full text Add to dashboard Cite

show abstract

“…Although some people with MCI function fairly well, a systematic review found that those with MCI felt that they were less relied upon and were a burden to others, and were frustrated with the reactions of family and friends to their reduced cognitive abilities [37]. They might have felt that they were no longer on 'equal terrain' with each other, and there was an experiential shift from the norm of their pre-existing relationship roles, which contributed to tension in the relationship [38].…”

Section: Discussionmentioning

confidence: 99%

A 'good dyadic relationship' between older couples with one having mild cognitive impairment: a Q-methodology

Cheung

Chan

et al. 2022

BMC Geriatr

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Background Cognitive impairment gradually brings changes to the relationship between older married couples. Therefore, this study aimed to understand the individual viewpoints of couple dyads on the important attributes of a 'good dyadic relationship' in the context of mild cognitive impairment (MCI), and to explore if the congruencies and discrepancies in their perceptions related to the quality and closeness of their relationship and well-being. Methods Q-methodology was used to reveal the perceptions of a ‘good dyadic relationship’ among couples with one having MCI. The participating couples were separated in two rooms and independently ranked 18 relationship attributes from least to most important on a 7-point Q-sort response grid. All participants also completed a post-sort interview and surveys to assess their psychological well-being and closeness. Q-sorts were analyzed using by-person factor analysis. Results Forty people with MCI and forty spousal partners completed the Q-sort. Three viewpoints, accounting for 48% of the total variance, were identified and were labeled ‘Provider,’ ‘Problem-solver,’ and ‘Partner.’ Different viewpoints of a ‘good dyadic relationship’ primarily varied by perceived importance of commitment, dedication, tolerance, and personal space. Despite these differences, there was wide consensus that respecting each other and cherishing the current moment are two universally salient attributes of a good relationship across all viewpoints. Couples with discrepant views scored significantly higher on perceptions of the quality of the relationship and closeness with the partner. Conclusions This study advances the theoretical understanding of the dyadic relationship between couples with one having MCI, from both perspectives. MCI is a state in which couples can openly discuss their expectations. The findings provide practitioners with insights to work with couples experiencing MCI.

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“…The kind of care is based on the diagnosis when accessing services at day care centres. It is frequently problematic to decide whether the benefits of obtaining a diagnosis outweighs the potential harms [77,78].…”

Section: Ethics Of Early Diagnosismentioning

confidence: 99%

Mild Cognitive Impairment in Relation to Alzheimer’s Disease: An Investigation of Principles, Classifications, Ethics, and Problems

Lee

2023

Neuroethics

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Mild Cognitive Impairment (MCI) is a diagnostic category indicating cognitive impairment which does not meet diagnostic criteria for dementia such as Alzheimer’s disease. There are public health concerns about Alzheimer’s disease (AD) prompting intervention strategies to respond to predictions about the impacts of ageing populations and cognitive decline. This relationship between MCI and AD rests on three interrelated principles, namely, that a relationship exists between AD and MCI, that MCI progresses to AD, and that there is a reliable system of classification of MCI. However, there are also several ethical issues and problems arising in the AD/MCI relationship. These include early diagnosis and interventions, the effects on people with MCI, and the newer neuroimaging and neuropharmacological approaches used in diagnosis and treatment. All these issues pose questions about the principles of MCI in relation to AD, with implications for how MCI is understood, diagnosed, treated, and experienced by patients. This article analyses four challenging areas for neuroethics: the definition and diagnosis of MCI; MCI in relation to AD; clinical implications of MCI for ethical disclosure, diagnosis, and treatment; and the research implications of MCI. The significant connections between these areas are often overlooked, together with uncertainties overall. Patients, healthcare systems and society are best served by informed clinicians, academics and researchers. After 35 years, the store of MCI knowledge is expanding and evolving.

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Patient Perspectives about Mild Cognitive Impairment: A Systematic Review

Cited by 14 publications

References 61 publications

Psychosocial impact of being diagnosed with mild cognitive impairment: patient and carer perspective

Psychosocial impact of being diagnosed with mild cognitive impairment: patient and carer perspective

A 'good dyadic relationship' between older couples with one having mild cognitive impairment: a Q-methodology

Mild Cognitive Impairment in Relation to Alzheimer’s Disease: An Investigation of Principles, Classifications, Ethics, and Problems

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