title: Living With Ambiguity: A Metasynthesis of Qualitative Research on Mild Cognitive Impairment.
abstract: OBJECTIVE
  Mild Cognitive Impairment (MCI) is a diagnosis proposed to describe an intermediate state between normal cognitive aging and dementia. MCI has been criticised for its conceptual fuzziness, its ambiguous relationship to dementia, and the tension it creates between medical and sociological understandings of "normal aging".
  
  
  METHODS
  We examined the published qualitative literature on experiences of being diagnosed and living with MCI using metasynthesis as the methodological framework.
  
  
  RESULTS
  Two overarching conceptual themes were developed. The first, MCI and myself-in-time, showed that a diagnosis of MCI could profoundly affect a person's understanding of their place in the world. This impact appears to be mediated by multiple factors including a person's social support networks, which daily activities are affected, and subjective interpretations of the meaning of MCI. The second theme, Living with Ambiguity, describes the difficulties people experienced in making sense of their diagnosis. Uncertainty arose, in part, from lack of clarity and consistency in the information received by people with MCI, including whether they are even told MCI is the diagnosis.
  
  
  CONCLUSIONS
  We conclude by suggesting an ethical tension is always at play when a MCI diagnosis is made. Specifically, earlier support and services afforded by a diagnosis may come at the expense of a person's anxiety about the future, with continued uncertainty about how his or her concerns and needs can be addressed.
authors: School of Health & Related Research, University of Sheffield, Sheffield, UK. nina.sperber@duke.edu.
authors: Tim
authors: T
authors: Gomersall
authors: School of Health & Related Research, University of Sheffield, Sheffield, UK.
authors: Arlene
authors: A
authors: Astell
authors: Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.
authors: Louise
authors: L
authors: Nygård
authors: Department of Gerontology, Simon Fraser University, Vancouver, Canada.
authors: Andrew
authors: A
authors: Sixsmith
authors: Toronto Rehabilitation Institute, University of Toronto, Toronto, Canada.
authors: Alex
authors: A
authors: Mihailidis
authors: Toronto Rehabilitation Institute, University of Toronto, Toronto, Canada.
authors: Amy
authors: A
authors: Hwang
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000523:psychology; D003704:Dementia / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008568:Memory; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D012944:Social Support
keywords: Attitudes and perception toward aging/aged; Cognition; Dementia; Ethics (research, practice, policy, individual choices); Qualitative research methods; Sociology of aging/social gerontology; Well-being