Dooley2020

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Dooley2020
BibType ARTICLE
Key Dooley2020
Author(s) Jemima Dooley, Cate Bailey, Penny Xanthopoulou, Nick Bass, Rose McCabe
Title Communication and Understanding of Mild Cognitive Impairment Diagnoses
Editor(s)
Tag(s) communication, diagnosis, mild cognitive impairment, prognosis, understanding, vascular cognitive impairment, EMCA
Publisher
Year 2020
Language English
City
Month
Journal International Journal of Geriatric Psychiatry
Volume 35
Number 6
Pages 662–670
URL Link
DOI 10.1002/gps.5284
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

Background Communication of mild cognitive impairment (MCI) diagnoses is challenging due to its heterogeneity and unclear prognosis. Aim To identify how MCI is communicated and to explore the relationship with patient and companion understanding.

Method Conversation analysis identified whether MCI was named and explained in 43 video recorded diagnosis feedback meetings. Afterward, patients and companions were asked to name the diagnosis to assess understanding.

Results Mild cognitive impairment was not named in 21\% meetings. Symptoms were explained as (a) a result of vascular conditions (49\%), (b) a stage between normal ageing and dementia (30\%), or (c) caused by psychological factors (21\%). Fifty-four percentage of prognosis discussions included mention of dementia. There was no association between symptom explanations and whether prognosis discussions included dementia. Fifty-seven percentage patients and 37\% companions reported not having or not knowing their diagnosis after the meeting. They were more likely to report MCI when prognosis discussions included dementia.

Conclusions Doctors offer three different explanations of MCI to patients. The increased risk of dementia was not discussed in half the diagnostic feedback meetings. This is likely to reflect the heterogeneity in the definition, cause and likely prognosis of MCI presentations. Clearer and more consistent communication, particularly about the increased risk of dementia, may increase patient understanding and enable lifestyle changes to prevent some people progressing to dementia.

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