Impact of cognitive impairment on mild dementia patients and mild cognitive impairment patients and their informants.
BACKGROUND
The aim of this study was to identify key aspects of the impact of cognitive impairment on patients with mild cognitive impairment (MCI) and mild probable Alzheimer disease (AD) and their informants, and identify overlap and differences between the groups.


METHODS
Structured focus group discussions were conducted with MCI patients, AD patients, MCI informants, and AD informants. Participants were recruited from memory clinics in the U.K. and the U.S.A. A total of 20 AD and 20 MCI patients and 16 AD and 11 MCI informants participated. Sessions were content reviewed to identify key impacts of cognitive impairment; results were compared across diagnostic groups and for patients and informants.


RESULTS
Seven key themes emerged: uncertainty of diagnosis, skill loss, change in social and family roles, embarrassment and shame, emotionality, insight, and burden. Patients were able to discuss the impact of cognitive impairment on their lives and reported frustration with recognized memory problems, diminished self-confidence, fear of embarrassment, concerns about changing family roles due to cognitive impairment, and anxiety. Informants reported more symptoms and more impairment than did patients and indicated increased dependence on others among patients.


CONCLUSIONS
MCI and mild AD exert substantial burden on patients' lives and the lives of those close to them.
Frank
Lori
L
The MEDTAP Institute at UBC, Bethesda, MD 20814, USA. lori.frank@unitedbiosource.com
Lloyd
Andrew
A
Flynn
Jennifer A
JA
Kleinman
Leah
L
Matza
Louis S
LS
Margolis
Mary Kay
MK
Bowman
Lee
L
Bullock
Roger
R
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology / Q000523:psychology*; D003072:Cognition Disorders / Q000523:psychology*; D003704:Dementia / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011369:Professional-Patient Relations; D011788:Quality of Life; D012720:Severity of Illness Index; D006113:United Kingdom; D014481:United States