Patient Perspectives about Mild Cognitive Impairment: A Systematic Review

ABSTRACT

Objectives

Mild cognitive impairment (MCI) is a concept that is steeped in controversy not limited to prognostic uncertainty; it is unclear how patients interpret or attribute meaning to the label, and whether they perceive that being made aware is beneficial.

Methods

A systematic review was conducted, searching ISI Web of Science, PubMed and PsycINFO in accordance with PRISMA guidelines. Search terms were developed to include articles concerning perceptions regarding MCI and experiences and impact of being informed. Thematic synthesis was applied to the findings.

Results

Fourteen papers met criteria. Three themes emerged regarding the MCI label: 1) Individual differences relating to living circumstances, personal perceptions and experiences, and coping style affect how patients adjust to the MCI label; 2) Patients’ reactions to the MCI label and their perceptions about how useful it was to receive are affected by the nebulous nature of the construct and information available regarding MCI; 3) Care partners are uncertain about what MCI means and how to address and cope with the patient’s cognitive difficulties.

Conclusions

Patient and care partner perspectives were affected by the quality of information and support provided, possibly influenced by clinicians’ understanding of the concept. Personal perceptions and experiences, living circumstance and coping styles also shaped experiences of being informed.

Clinical Implications

Clinicians should develop their understanding of MCI to deliver clear information to patients and consider the necessity of applying the label. Offering support tailored to patients’ specific needs may improve perceptions about the label’s utility, whilst aiding coping and adjustment.

KEYWORDS:

• Mild cognitive impairment
• cognitive decline
• MCI
• aging
• impact
• utility
• coping

Clinical Implications

• Clinicians should be mindful that the MCI concept remains nebulous, and consider that inherent lack of understanding about what the MCI label means may impact on patient and care-partner adjustment. Clinicians should attempt to develop their own understanding of the label to enable provision of clear information to patients, using non-technical language.

• Once clinicians have a well-developed understanding about what MCI means, they should consider incorporating these explanations in to patient-friendly leaflets. The leaflets could also provide more in-depth information about MCI that there may not be time to discuss in the appointment.

• Clinicians should consider using a formulation-driven and person-centered approach when informing individuals of MCI. This would enable consideration of the varied factors that affect adjustment, and the utility of applying the label to the cognitive condition of the individual patient. Service commissioners and clinicians should consider the need for tailored follow-up and potential options for further interventions.

Acknowledgments

The authors would like to thank Dr Georgina Charlesworth for offering guidance relating to the thematic synthesis.

Disclosure statement

The authors declare no conflict of interest.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

No funding was received when writing this review.