Experiences Surrounding an Early-Stage Cognitive Diagnosis in Rural-Dwelling Older Adults

Misdiagnosis, lack of specialists, and patient dismissal of symptoms can contribute to delayed detection of early cognitive impairment. Understanding patient perspectives during and around time of cognitive diagnosis is crucial, as reactions to diagnosis can impact disease management and overall health. The current study conducted semi-structured interviews to explore the experiences of rural-dwelling older adults (n = 9) and their caregivers (n = 10) surrounding diagnosis of mild cognitive impairment or early-stage Alzheimer's disease at a specialty research center (SRC). Content analysis was performed. Overall, researchers found that older adult participants experienced various cognitive symptoms pre-diagnosis and dyads experienced diagnostic uncertainty prior to the SRC visit. All individuals displayed a range of reactive and information-seeking actions. Nurses play significant roles in the diagnostic and post-diagnostic periods for patients with early-stage cognitive impairment, and clinical diagnostic expertise, appropriate and timely direction of resources, and identification and targeting of early interventions to promote cognitive health are particularly important to this underserved population. [Res Gerontol Nurs. 2018; 11(4):181-189.].