Quality of life in persons with mild cognitive impairment: a systematic review and meta-analysis

Gopalakrishnan, Priya; Tiwari, Shivani; Nagaraja, Ravishankar; Krishnan, Gopee

doi:10.1590/1980-5764-DN-2023-0093

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Dementia & Neuropsychologia

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View & Review • Dement. neuropsychol. 18 • 2024 • https://doi.org/10.1590/1980-5764-DN-2023-0093 copy

Quality of life in persons with mild cognitive impairment: a systematic review and meta-analysis

Qualidade de vida em pessoas com comprometimento cognitivo leve: uma revisão sistemática e metanálise

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The global increase in the aging population has raised concerns over various age-related conditions like dementia and mild cognitive impairment (MCI) and their consequences on the affected persons. People with MCI exhibit cognitive deficits more significantly than expected for their age and literacy level. Though the nature of this condition is considered "mild", studies have reported that even more subtle deficits can influence the quality of life (QOL).

Objective:

The present work aimed at exploring and comparing QOL in older adults with and without MCI through a systematic review and meta-analysis.

Methods:

After a detailed search of articles till May 2021 in the relevant electronic databases (PubMed Central, PubMed, Scopus, CINAHL Plus, Web of Science, ProQuest, and Cochrane) using the keywords "mild cognitive impairment", "quality of life", "old", "old aged", "aged", "older adult", "geriatrics", "healthy controls", "healthy participants", and "normal controls", we included 23 articles in the systematic review and 12 in the meta-analysis.

Results:

The quality of all the included articles were assessed using the Modified Downs and Black tool. Most of the studies in the systematic review demonstrated differences in QOL scores in older adults with MCI compared to healthy older adults. However, meta-analysis findings suggest that older adults with MCI had statistically non-significant yet lower differences in QOL compared to their healthy counterparts.

Conclusion:

Future research should focus on developing QOL assessment tools specifically for older adults with MCI and follow-up studies that could provide better knowledge of their changing cognitive profile and life quality.

Keywords:
Quality of Life; Cognitive Dysfunction; Aged; Systematic Review; Meta-analysis

Reference	Year	Age (years)	Sample size	Study design	Tools for assessing MCI	Tools for assessing QOL	Outcome measures
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Maki et al.²⁹29 Maki Y, Yamaguchi T, Yamagami T, Murai T, Hachisuka K, Miyamae F, et al. The impact of subjective memory complaints on quality of life in community-dwelling older adults. Psychogeriatrics. 2014;14(3):175-81. https://doi.org/10.1111/psyg.12056 https://doi.org/10.1111/psyg.12056...	2014	≥ 65 HC 71.9±4.1 MCI 73.1±4.4	HC=120 MCI=37	Cross sectional	MCI was diagnosed by a physician. MMSE 5-Cog test: memory test and executive function test	SDL Japanese version	Impacts of memory complaints on QOL
Missotten et al.²⁷27 Missotten P, Squelard G, Ylieff M, Di Notte D, Paquay L, De Lepeleire J, et al. Quality of life in older Belgian people: comparison between people with dementia, mild cognitive impairment, and controls. Int J Geriatr Psychiatry. 2008;23(11):1103-9. https://doi.org/10.1002/gps.1981 https://doi.org/10.1002/gps.1981...	2008	≥ 65 HC 79.2±6.76 MCI 83.7±7.0	HC=72 MCI=36	Cross sectional	MMSE Petersen criteria	ADRQL	Sensitivity of ADRQL
Muangpaisan et al.³²32 Muangpaisan W, Assantachai P, Intalapaporn S, Pisansalakij D. Quality of life of the community-based patients with mild cognitive impairment. Geriatr Gerontol Int. 2008;8(2):80-5. https://doi.org/10.1111/j.1447-0594.2008.00452.x https://doi.org/10.1111/j.1447-0594.2008...	2008	≥ 50 HC 63.9±7.9 MCI 66.7±8.0	HC=37 MCI=85	Cross sectional	Petersen criteria	WHOQOL-BREF-Thai version	QOL
Onandia-Hinchado and Diaz-Orueta⁴¹41 Onandia-Hinchado I, Diaz-Orueta U. Health related quality of life and cognitive decline in older populations: Preliminary results from NeuroDemeNPsia study. J Appl Gerontol. 2020;39(6):618-26. https://doi.org/10.1177/0733464819866587 https://doi.org/10.1177/0733464819866587...	2019	HC 75.0±6.7 (62–91 years) MCI 70.8±11.5 (54–85 years)	HC=31 MCI=43	Cross sectional	Criteria from SEN	SF12v2	HRQOL
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QOL Measure	Domains	Score
SF-36	physical functioning, role limitations due to physical health, pain, general health, energy/fatigue, social functioning, role limitations due to emotional problems, emotional well-being	0–100
EQ-5D	mobility, self-care, usual activities, pain/discomfort, anxiety/depression	Index value +1 to −1
WHOQOL-BREF	physical health, psychological state, social relationships, environmental context	5-point Likert scale
DQOL	positive affect, negative affect, feelings of belonging, self-esteem, sense of aesthetics	5-point Likert scale
QOL-AD	physical health, energy, mood, living situation, memory, family, marriage or close relationship, friends, self as a whole, ability to do chores around the house, ability to do things for fun, money, life as a whole	4-point Likert scale
ADRQL	social Interaction, awareness of self, feelings and mood, enjoyment of activities, response to surroundings	0–100%
SDL	physical health, mental health, self-care, gait, housework, house facilities, partner and family relationship, hobby and leisure activities, social interaction, economic state and social security, job satisfaction	5-point Likert scale
LASA	physical well-being, emotional state, faith, religious involvement, intellectual state, social interactions, pain frequency, pain intensity, coping ability	10-point Likert scale
HRQOL	Single-item overall quality-of-life rating	5-point Likert scale
WHOQOL- OLD	sensory abilities; autonomy; past, present, and future activities; social participation; fears related to death and dying; and intimacy	0–100
DEMQOL	Degree of difficulty in daily life related to health, well-being, cognitive functioning, social relationships, daily activities, and self-concept	0–100
CUBRECAVI	health (subjective, objective and psychic); social integration; functional abilities; activity and leisure time; quality of environment; satisfaction with life; education; income; health and social services	5-point Likert scale
SF12	Physical Function, Physical Role, Body Pain, General Health, Vitality, Social Function, Emotional Role, and Mental Health	0–100

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[1] Correspondence:
Gopee Krishnan; Email: brain.language.krishnan@gmail.com.