A Conceptualization of Mild Cognitive Impairment

Saturday, 16 November 2013

Jennifer Marie Sjostedt, RN, MSN
Marquette University, Milwaukee, WI

Learning Objective 1: The learner will be able to identify the potential attributes, antecedents, and consequences in the newly developed conceptual model of mild cognitive impairment.

Learning Objective 2: The learner will be able to apply the newly developed conceptual model of mild cognitive impairment to develop future research or clinical projects.

Background. Mild cognitive impairment (MCI) is often viewed as a transitional state to dementia and other neurocognitive disorders. A conceptual framework for MCI might help to guide research; but one does not appear to exist. Most published studies use only diagnostic criteria and do not specify a framework as the basis for their research. The purpose of this analysis is to explore the concept of MCI in order to provide a framework for future research and broaden the understanding of older adults’ potential experiences with MCI.

Method. Google-scholar, CINHAL, Proquest dissertations and PubMed databases were searched for years 2000-2010, and the search was repeated in 2011-2012 to include more recent literature. The search was limited to publications in English. Search terms focused on the attributes, sociocultural, temporal, and discipline variations of MCI among older adults.

Results. A total of 52 articles and 2 comprehensive books were reviewed. The antecedents and consequences of MCI from the older adults’ perspectives were identified, leading to the definition of MCI as a state of unstable limbo weighted by heterogeneity between a person’s normal and abnormal continuums. Antecedents included attributes that were modifiable (lifestyle factors, dietary deficiencies, medications, and stress), potentially modifiable (chronic conditions, neuropsychiatric disorders, and a lack of awareness of deficits), and non-modifiable (sociodemographic and neuropathologic factors). The consequences of MCI were identified as being complex and enveloped by ambiguity, confusion, variability and uncertainty.

Conclusions. The analytic synthesis of the literature resulted in a conceptual model of MCI.  The model illustrates the complexity and nature of MCI and provides a framework to guide the development of new interventions and research.