Page 329 - Encyclopedia of Nursing Research

296 n MILD COGNITIVE IMPAIRMENT

a vibrant middle-range theory base guiding define a commonly observed clinical condi-
the discipline of nursing. Simply proposing a tion characterized by the presence of mild
M middle-range theory without ongoing testing cognitive deficits that preceded dementia
renders the theory of little use to the disci- and that might therefore be useful in predict-
pline. Therefore, it is imperative that existing ing dementia (Molinuevo, Valls-Pedret, &
middle-range theories be used, tested, and Rami, 2010). The term MCI was originated by
refined and that findings from these endeav- Flicker, Ferris, and Reisberg (1991) to describe
ors be published. individuals who exhibited cognitive diffi-
There continues to be a need for relevant culties at or about stage three on the Global
discipline-specific theories developed at the Deterioration Scale (Reisberg, Ferris, de Leon,
middle-range level of discourse. Population & Cook, 1982) but who did not meet the clini-
or disease-specific theories are not at the cal criteria for a diagnosis of dementia. In the
middle range. A nursing theory framed at late 1990s, Petersen et al. (1999) proposed a set
the middle-range level of discourse can be of criteria for the MCI concept. These were
applied across populations and with persons that (1) the individual themselves reported
in differing complex health circumstances. memory problems, preferably corroborated
Nurse educators are challenged to inte- by an informant; (2) their general cognition
grate middle-range theories into curricula was essentially normal; (3) their activities
so that students become familiar with these of daily living functioning was essentially
theories as structures that guide practice normal; (4) objectively, any memory impair-
and research. If educators accept this chal- ment was commensurate with their age and
lenge, building nursing knowledge would educational level; (5) and they did not have
shift from an esoteric endeavor to frontline dementia. However, a significant proportion
activity for nursing practice. Likewise, nurs- of MCI patients were subsequently found to
ing scholars have a responsibility to niche exhibit deteriorations in other areas of cog-
research into appropriate nursing theories, nition leading a team of researchers at the
thus contributing to the substantive body of Mayo Clinic to revise the criteria of Petersen
nursing knowledge. et al. They therefore proposed a set of sub-
types to classify a wider range of people
Patricia Liehr with cognitive impairment (Petersen et al.,
Mary Jane Smith 2001). The amnesic subtype of MCI equates
with the general criteria for MCI outlined
by Petersen et al. (1999). This subtype is
most likely to convert to Alzheimer’s dis-
Mild cognitive iMPairMent ease (AD) (Molinuevo et al., 2010). Amnesic
multidomain MCI involves memory impair-
ment with slight alterations in other areas
Mild Cognitive Impairment (MCI) is a term of cognition, whereas isolated nonamnesic
used to describe individuals who lie some- MCI describes individuals whose memory is
where between normal aging and dementia intact but who have impairment in one aspect
in regard to their cognitive ability (Dubois of their cognitive domain. Hence, there are
& Albert, 2004). As far back as the early many variants of nonamnesic MCI depend-
nineteenth century, Pritchard (1837, cited ing on which aspect of cognition is involved,
in Gauthier et al., 2006) described the early and it is thought that each will progress to
stages of dementia as the impairment of different clinical entities (Molinuevo et al.,
recent memories with intactness of distant 2010). Finally, multidomain nonamnesic MCI
memories. Then, in the latter part of the describes individuals who have deficits in
twentieth century, researchers sought to two areas of cognition but whose memory