Division of Psychiatry, 4919University College London, London, UK.
Dementia (London). 2023 Feb;22(2):439-474. doi: 10.1177/14713012221147710. Epub 2022 Dec 27.
Many older people experience memory concerns; a minority receive a diagnosis of Mild Cognitive Impairment (MCI) or Subjective Cognitive decline (SCD). There are concerns that medicalisation of MCI and memory concern may fail to acknowledge subjective experiences.
We explore the meaning individuals give to their memory concerns, with or without a diagnosis of MCI and SCD.
We scoped literature exploring subjective experiences of memory concern, with or without a diagnosis of MCI or SCD. We searched CINAHL, PsycINFO and MEDLINE in March 2020, and updated in Sept 2021.We used (Arksey & O'Malley, 2005) framework to guide our scoping review method and thematic analysis to analyse our findings.
We screened 12,033 search results reviewing the full texts of 92 papers. We included 24 papers, including a total of 453 participants, the majority of whom were female, from White ethnic majority populations (or from studies where ethnicity was not identified) with high levels of education. In 15 out of 24 studies, 272 participants were diagnosed with MCI. We identified two themes; and . We found that subjective experiences include normative comparison with others of the same age and responses including fear, relief, and acceptance, but culminating in uncertainty.
Drawing upon sociology, we highlight the subjective experiences of living with memory concerns, SCD and an MCI diagnosis. We identify a gap between the intended purpose of diagnostic labels to bring understanding and certainty and the lived experiences of those ascribed them.
许多老年人都有记忆问题;少数人被诊断为轻度认知障碍(MCI)或主观认知下降(SCD)。有人担心,MCI 和记忆问题的医学化可能无法承认主观体验。
我们探讨了有或没有 MCI 和 SCD 诊断的个体对其记忆问题的主观体验的意义。
我们综述了探索有或没有 MCI 或 SCD 诊断的个体对记忆问题的主观体验的文献。我们于 2020 年 3 月在 CINAHL、PsycINFO 和 MEDLINE 进行了检索,并于 2021 年 9 月进行了更新。我们使用(Arksey & O'Malley,2005)框架来指导我们的范围综述方法,并使用主题分析来分析我们的发现。
我们筛选了 12033 条搜索结果,对 92 篇论文的全文进行了审查。我们共纳入了 24 篇论文,共计 453 名参与者,其中大多数为女性,来自白人多数族裔(或在研究中未确定种族),教育程度较高。在 24 项研究中的 15 项中,有 272 名参与者被诊断为 MCI。我们确定了两个主题;和。我们发现,主观体验包括与同龄人的正常比较,以及包括恐惧、宽慰和接受在内的反应,但最终导致不确定感。
我们借鉴社会学的观点,强调了患有记忆问题、SCD 和 MCI 诊断的个体的主观体验。我们发现,诊断标签的预期目的是提供理解和确定性,而那些被贴上标签的人的实际体验却存在差距。