Living with Ambiguity: A Metasynthesis of Qualitative Research on Mild Cognitive Impairment

Timothy Gomersall, Arlene Astelle, Louise Nygård, Andrew Sixsmith, Alex Mihailidis, Amy Hwang

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose of the study:
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'.

Design and 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.

Implications: 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.
LanguageEnglish
Pages892-912
Number of pages21
JournalThe Gerontologist
Volume55
Issue number5
Early online date27 Aug 2015
DOIs
Publication statusPublished - 1 Oct 2015
Externally publishedYes

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Qualitative Research
Social Support
Uncertainty
Dementia
Cognitive Dysfunction
Anxiety

Cite this

Gomersall, Timothy ; Astelle, Arlene ; Nygård, Louise ; Sixsmith, Andrew ; Mihailidis, Alex ; Hwang, Amy. / Living with Ambiguity : A Metasynthesis of Qualitative Research on Mild Cognitive Impairment. In: The Gerontologist. 2015 ; Vol. 55, No. 5. pp. 892-912.
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Gomersall, T, Astelle, A, Nygård, L, Sixsmith, A, Mihailidis, A & Hwang, A 2015, 'Living with Ambiguity: A Metasynthesis of Qualitative Research on Mild Cognitive Impairment', The Gerontologist, vol. 55, no. 5, pp. 892-912. https://doi.org/10.1093/geront/gnv067

Living with Ambiguity : A Metasynthesis of Qualitative Research on Mild Cognitive Impairment. / Gomersall, Timothy; Astelle, Arlene; Nygård, Louise; Sixsmith, Andrew; Mihailidis, Alex; Hwang, Amy.

In: The Gerontologist, Vol. 55, No. 5, 01.10.2015, p. 892-912.

Research output: Contribution to journalArticle

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T1 - Living with Ambiguity

T2 - The Gerontologist

AU - Gomersall, Timothy

AU - Astelle, Arlene

AU - Nygård, Louise

AU - Sixsmith, Andrew

AU - Mihailidis, Alex

AU - Hwang, Amy

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Purpose of the study: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'.Design and 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.Implications: 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.

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KW - Well-being

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