Mild cognitive impairment: coping with an uncertain label Liesbeth Joosten-Weyn Banningh 1 * , Myrra Vernooij-Dassen 2 , Marcel Olde Rikkert 3 and Jan-Pieter Teunisse 1 1 Radboud University Nijmegen Medical Centre, Department of Medical Psychology, the Netherlands 2 Alzheimer Centre Nijmegen, Centre for Quality of Care Research, the Netherlands 3 Alzheimer Centre Nijmegen, Department of Geriatrics, the Netherlands SUMMARY Background The recently introduced diagnostic label of Mild Cognitive Impairment (MCI) identifies patients with a cognitive decline that is more pronounced than is usual for a person’s age and educational level but does not notably interfere with activities of daily living (ADL). The natural course of the syndrome is uncertain although MCI sufferers have a higher risk of developing dementia. Objectives To investigate how patients fulfilling MCI criteria experience and cope with their cognitive decline with the secondary aim to derive key themes for a prospective MCI support-group programme. Methods The grounded theory approach. Results Analysis of guided interviews with eight MCI patients revealed four common themes. Changes related to cognitive abilities, mobility, affect, vitality and somatic complaints. Attributions were numerous and concerned aetiologies such as personality traits and overload of information. Consequences were all negative and concerned the patients themselves such as anxiety and loss of self-confidence, others such as feelings of irritation and anger towards others or activities like abandoning leisure activities. Patients applied emotion-oriented, problem-focused and avoidant coping strategies. Conclusion MCI patients encounter stress-inducing practical, social and psychological difficulties. Based on the current preliminary findings, the key themes for an MCI support-group programme should include the provision of information about the syndrome’s causes, course, concomitant symptoms, attributions, social consequences, and available treatments. The impact of receiving an MCI label warrants further investigation. Copyright # 2007 John Wiley & Sons, Ltd. key words — Mild Cognitive Impairment; coping; qualitative; experience; psychosocial consequences INTRODUCTION Improvements in diagnostics have caused a shift in the diagnosis of Alzheimer’s disease (AD) and other dementias towards earlier stages (Olde Rikkert et al., 2006). Early diagnoses allow well-timed treatments and psychosocial interventions preventing secondary problems. Increasingly, individuals exhibiting cogni- tive deficits that exceed the normal physiological aging processes but do not fulfil the criteria for demen- tia are being identified. Petersen et al. (2001) proposed the concept of Mild Cognitive Impairment (MCI) to describe this state of below-normal cognitive func- tioning. This clinical label is applied to people suf- fering from cognitive impairments, which unlike dementia do not significantly impede activities of daily living. Yet, despite abundant evidence that MCI indeed is a syndrome with a high rate of progression to AD in particular, not all patients with MCI will develop dementia (Panza et al., 2005). Longitudinal and pros- pective studies reported annual MCI–dementia con- version rates from 6–25%, (Feldman and Jacova, 2005; Panza et al., 2005). People diagnosed with MCI may show further cognitive decline, stabilise, or even improve. Hence, the diagnosis may increase people’s uncertainty, forcing them to reappraise their INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Int J Geriatr Psychiatry 2008; 23: 148–154. Published online 19 June 2007 in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/gps.1855 *Correspondence to: Dr L. Joosten-Weyn Banningh, 840 Medical Psychology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail: l.joosten@ger.umcn.nl Copyright # 2007 John Wiley & Sons, Ltd. Received 11 November 2006 Accepted 4 May 2007