Illness perceptions in older adults with mild cognitive impairment: A systematic review and framework synthesis

Mild cognitive impairment (MCI) is a transitional state between normal cognitive aging and dementia, representing a critical window for intervention. However, older adults with MCI often lack accurate illness perceptions, which may impede early intervention and self-management behaviors. Understanding how older adults perceive their condition is essential for developing patient-centered care strategies. The objectives of this review were (1) to systematically synthesize qualitative evidence on illness perceptions in older adults with MCI using the Common-Sense Model (CSM) as a theoretical framework, and (2) to identify key dimensions of illness representations that influence older adults' coping and management strategies.

Eleven databases (i.e., PubMed, Medline, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, CNKI, VIP, Sinomed, and Wanfang) and Google Scholar were used to conduct the searches. We included qualitative studies examining illness perceptions in older adults aged 60 and above with MCI diagnoses. The quality of literature was assessed using the Critical Appraisal Skills Programme (CASP).

Twenty-three studies were included. older adults experience varied symptoms, attribute conditions to different causes, and have diverse beliefs about the illness's timeline and consequences. The effects extend beyond cognitive changes to personal identity, social interactions, daily life, physical health, and family dynamics. older adults employ various control and management strategies, with attitudes toward recovery ranging from active control to passive acceptance. older adults predominantly exhibit negative emotional responses to potential outcomes.

This qualitative synthesis shows heterogeneity in illness perceptions. These findings should inform healthcare providers in developing more targeted and efficient individualized education and self-management interventions to correct misconceptions about MCI, enhance self-management capabilities, and improve intervention adherence in older adults with MCI.