Understanding the experiences of older adults living with MCI can benefit healthcare professionals in diagnosing and implementing early interventions to delay cognitive decline.
ObjectiveTo assess and synthesize qualitative research exploring the experience of older adults diagnosed with MCI.
MethodsPubMed, Embase, CINAHL, Web of Science, and PsycINFO databases were searched. Studies involving the experience of being diagnosed with MCI in older adults were included. Thomas and Harden's methodology of synthesizing qualitative studies was used.
ResultsEleven studies were included. Three themes were identified: perceived reality of the MCI diagnosis; emotional and psychological responses to the MCI label; coping engaged in parallel processing. Older adults had confusing perspectives on the MCI diagnosis, leading to complicated and diverse emotional reactions and coping measures.
ConclusionsThe relationship between perspectives, emotional reactions, and coping methods might be the key for healthcare professionals to break through the early diagnosis and intervention of MCI.
Section snippetsBackgroundMild cognitive impairment (MCI) is becoming increasingly prevalent in older people, which is used to describe a stage of cognitive impairment between that seen in ‘normal’ aging and dementia.1 Living with cognitive decline not only severely affects older adults' quality of life and daily living ability but also increases their risk of progressing to dementia. The cumulative incidence of dementia among adults older than 65 with MCI in the United States at two years of follow-up was 14.9 percent.2
MethodsThis systematic review was conducted to assess and synthesize qualitative research exploring the experience of older adults diagnosed with MCI. A narrative synthesis approach was used to compare and combine qualitative methods studies. This review was undertaken following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ)27 and had been registered in PROSPERO. The registration number is CRD42021288724.
Search strategyStudies published in English were identified by conducting electronic searches in PubMed, Embase, CINAHL, Web of Science, and PsycINFO from their earliest dates to November 2021. The reference list of included studies and unpublished studies were also searched to identify relevant literature in line with the inclusion criteria. Based on the population, exposure, outcome, study (PEOs) model,28 four paging blocks of keywords – ‘older adults’, ‘mild cognitive impairment’, ‘experiences’, and
Study selectionThe search results were imported into and managed by EndNote(X9) software to remove duplicate records and complete the study selection process by two researchers separately (MJY, ZH). A third researcher (LZ) adjudicated any disputes encountered during cross-check. The selection process and results were reported in a flow diagram following PRISMA 2020 guidelines29 for reporting systematic reviews. Studies were included if they: (1) used qualitative research designs, qualitative data collection,
Quality appraisalThe quality of included studies was appraised according to the JBI Critical Appraisal Checklist for Qualitative Research.30 Two researchers (MJY, ZH) independently reviewed each study following the checklist. If differences were found between the reviews of the two researchers, the third researcher (LZ) was involved in reaching a consensus. The checklist consists of 10 items evaluating the study aims, methodology, research designs, data collection and analysis methods, relationships between
Data extraction and analysisTwo reviewers (MJY, ZH) independently performed data extraction using a standardized template designed for this review and cross-checked for accuracy. Tables were created to extract and present the demographic (Table 1) and methodological (Table 2) characteristics of the involved studies, including authors, countries, year of publication, sample size, participants' age, sex, ethnicity, diagnosis type, and main purpose, study design, data collection, data analysis, and main themes. In addition,
Record retrieval resultsA total of 4,706 studies were retrieved. After finding duplicates and reviewing the titles and abstracts, 4,635 studies were excluded. Following a review of 71 full texts, 11 studies that fulfilled the inclusion criteria were retrieved (Fig. 1).
Quality appraisal of the included studiesTen included studies had good quality as they clearly described at least eight of the ten items (Supplemental Material Table 2). Three studies clearly described all the ten items of the quality appraisal. Only five studies clearly stated the influence
DiscussionThis systematic review provides further insight into older adults' understanding of the MCI label and their experiences and responses to being diagnosed with MCI. Eleven sub-themes were identified and formed into three themes, which revealed the considerable uncertainty and incomprehension of MCI expressed by older adults, especially those who experienced fear or distress about the MCI label and consequently lack self-confidence and withdraw from social and leisure activities. Even the older
ConclusionsOverall, our study revealed a wide range of older adults' interpretations of an MCI diagnosis, aggregating perspectives on their experiences from exposure to the diagnosis, emotional and psychological responses to the diagnosis, and coping measures based on the included studies. The experiences of getting and coping with the MCI label of older adults within this context is complex, multifaceted, and have similarities worldwide, where MCI seems to have been added to the list of stigmatized
Funding sourcesNone.
Conflict of interestNone.
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