Psychosocial adjustment to Mild Cognitive Impairment: The role of illness perceptions, cognitive fusion and cognitive impairment

Abstract

Background and objective Receiving a Mild Cognitive Impairment diagnosis and adjusting to this condition is challenging, given the uncertain clinical trajectory surrounding progression to dementia. We aimed to explore the influence of illness perceptions and cognitive fusion on coping and emotional responses in a sample of people diagnosed with Mild Cognitive Impairment. Research design and method: A cross-sectional study of 34 participants with Mild Cognitive Impairment (47% female and 53% male; mean age 76.4 years) evaluated the relationships between cognitive impairment, illness perceptions and cognitive fusion on levels of distress and quality of life. Participants completed standardised measures for cognitive assessment, illness perceptions, cognitive fusion, depression, anxiety and quality of life. Relationships between variables were analysed using correlation, regression and conditional process analyses. Results At the group level, illness perceptions were found to be a stronger predictor of depression and quality of life in the current sample than objective cognitive impairment. Illness perceptions did not directly predict anxiety, rather cognitive fusion significantly mediated this relationship. Cognitive fusion also significantly mediated the relationship between illness perceptions and depression. Illness perceptions had a significant, direct effect on quality of life; however, there was no significant indirect effect via cognitive fusion. Greater fusion with threatening illness perceptions was significantly related to increased anxiety and depression. Discussion and implications: Data suggest multiple potential treatment targets in helping people diagnosed with Mild Cognitive Impairment to successfully adapt and adjust. Targeting appraisals (illness perceptions) using Cognitive Therapy is one potential treatment target. In addition, psychological treatments such as Acceptance and Commitment Therapy, which target cognitive fusion, could also warrant further investigation in this population, due to the significant indirect paths from illness perceptions to distress and quality of life, via cognitive fusion.