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Adjustment to test, risk and diagnostic disclosures in people with mild cognitive impairment: An observational cohort study
Author(s) -
Saunders Stina,
MuñizTerrera Graciela,
Russ Tom C,
Ritchie Craig W.
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.054077
Subject(s) - repeatable battery for the assessment of neuropsychological status , worry , anxiety , clinical psychology , cognition , cohort , psychology , feeling , depression (economics) , longitudinal study , observational study , medicine , neuropsychology , psychiatry , social psychology , pathology , economics , macroeconomics
Background Mild cognitive impairment (MCI) is a condition with slight decline in cognition, but unaffected daily functioning. Given its uncertain prognosis, communicating this in clinical consultations with patients is crucial. Our aim was to understand the impact of clinical risk reporting to individuals with newly identified MCI, focusing on changes in cognition, anxiety, psychological well‐being and adjustment to illness in the short and long term. Method This is a longitudinal mixed methods study. Participants who were referred to a memory clinic with a suspected MCI were recruited from across South‐East Scotland. Baseline assessments (June 2018‐July 2019) were conducted before the MCI risk disclosure. Follow up assessments started after individuals were disclosed of memory assessment results and were carried out over two years (completed by May 2021 due to COVID‐19 restrictions). The primary outcome measures are neuropsychological assessment (RBANS), anxiety assessment (STAI) and results from semi‐structured interviews. Result There are 63 individuals recruited (men = 25, 40%; women = 38, 60%); average age 77 years, SD=6.76; average years of education 13 (mode 10). At baseline, the mean RBANS score was 87 (SD=15.79); STAI score 81 (SD=20.59). A higher RBANS score at baseline was predicted by more years of education and higher score in ‘Attitude toward present treatment & doctors.’ Being identified as having MCI was predicted by higher perceived deficits and feelings of depression and worry. Longitudinal analyses of adjustment to MCI will be presented at the conference. Initial results of the interviews show that the concept of MCI is perceived with mixed feelings, with the immediate response to disclosure more positive and as time goes on, the initial perception shifting. Conclusion Baseline RBANS results are consistent with other research on the same clinical population. This study gives empirical evidence on the impact of being informed of test results at the pre‐dementia or early dementia stages where future prognosis is uncertain. The longitudinal data will be used to identify modifiable risk factors for adjusting to MCI disclosure well or less well.