Making sense of mild cognitive impairment: a qualitative exploration of the patient's experience.
OBJECTIVE
The proposed dementia precursor state of mild cognitive impairment is emerging as a primary target of aging research. Yet, little is known about the subjective experience of living with a diagnosis of mild cognitive impairment. This study examines, from the patient's perspective, the experience of living with and making sense of the diagnosis.


METHODS
We recruited 12 older adults with amnestic or nonamnestic mild cognitive impairment from a university-based memory disorders clinic. We conducted in-home, semistructured interviews in order to elicit rich descriptions of the personal experience of having mild cognitive impairment. We used the qualitative method of grounded theory to analyze narrative data.


RESULTS
Understanding and coming to terms with the syndrome, or assigning meaning, constituted a fundamental aspect of living with a diagnosis of mild cognitive impairment. This process comprised interrelated emotional and cognitive dimensions. Participants employed a range of positive, neutral, and negative phrasing in order to depict their emotional reactions to receiving a diagnosis. Cognitive representations of mild cognitive impairment included both prognosis-focused and face-value appraisals. Expectations of normal aging, personal experience with dementia, and concurrent health problems were key contextual factors that provided the backdrop against which participants assigned meaning to a diagnosis of mild cognitive impairment.


CONCLUSIONS
Clinicians who disclose diagnoses of mild cognitive impairment need to be mindful of the potential for varying interpretations of the information that is conveyed. Future research needs to include systematic, longitudinal investigations of illness representation and its impact on health behaviors among individuals with mild cognitive impairment.
Lingler
Jennifer Hagerty
JH
Department of Psychiatry, Alzheimer Disease Research Center, University of Pittsburgh School of Medicine, 121 University Place, Pittsburgh, PA 15260, USA. linglerjh@upmc.edu
Nightingale
Marcie C
MC
Erlen
Judith A
JA
Kane
April L
AL
Reynolds
Charles F
CF
Schulz
Richard
R
DeKosky
Steven T
ST
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003072:Cognition Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index