Meta-representational awareness in mild cognitive impairment: an interpretative phenomenological analysis

Awareness in mild cognitive impairment (MCI) has been studied primarily from a quantitative perspective, which has yielded inconclusive results. A qualitative approach may provide a more in-depth profile of awareness of symptoms and changes among people living with MCI. Few qualitative studies have considered awareness in MCI; therefore, the focus here will be on the experience of living with MCI, and particularly on the psychological impact of living with memory difficulties and how these impact on daily life. Twenty five participants with a clinical diagnosis of MCI who had been informed of their diagnosis were interviewed. Interpretative phenomenological analysis was used to analyse interview transcripts. Four higher order themes were identified. An exploratory model is proposed with a dominant theme of 'Fear and uncertainty'; this underpins 'Interdependence', 'Life goes on as normal' and 'Disavowal of difficulty' which are representative of coping responses resulting from appraisal of memory and cognitive difficulties. Participants did not use the term 'MCI', suggesting that this term had little meaning for them; nevertheless, there was a wish for a definitive explanation of the difficulties. The themes elicited from participant accounts indicate that the symptoms of MCI are perceived as a threat to psychological well-being which results in context-specific appraisal of the symptoms of MCI.