Persons With Mild Cognitive Impairment Research Articles

Predictors of decisional capacity in AD biomarker test candidates

AbstractBackgroundDeciding to learn one’s Alzheimer’s disease (AD) biomarker status requires comprehending and deliberating about complex and nuanced information. Assessing capacity to consent to AD biomarker testing and disclosure is further complicated when candidates have cognitive impairment and present with family care partners. The objective of this analysis was to identify predictors of decisional capacity for an amyloid PET disclosure study among persons with Mild Cognitive Impairment (PwMCI) and their care partners (CPs).MethodThis investigation was a secondary analysis, using baseline data of a randomized controlled trial of amyloid PET results disclosure. Multiple linear regression modeling was used to examine predictors of decisional capacity, measured by the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). Focusing on PwMCI (n = 82), the predictor variables of interest were sociodemographic characteristics, and level of knowledge on MCI/AD and normal aging, global cognition measured by Mini Mental Status Exam (MMSE), and neuropsychological tests of language and executive functioning. Dyadic analyses were conducted with CP data (n = 82), using the Actor Partner Interdependence Model (APIM) to assess for presence of partner effects among key variables.ResultParticipants and CPs were mostly White (91.5%, 90.2%), highly educated (16.5, 15.5 years on average), with mean age 72.7 and 66.8 years, respectively. CPs tended to be female, and spouses of the participants (70.7%). MMSE scores (b = 0.215, SE = 0.082, p = 0.011) and MCI/AD knowledge scores (b = 0.241, SE = 0.101, p = 0.020) positively predicted decisional capacity for PwMCI. Dyadic analysis using APIM showed that level of MCI/AD knowledge (p = 0.019) and level of education (p<0.001) were highly correlated within the dyad. Furthermore, analyses revealed significant positive correlations for MCI/AD knowledge for actor relations for decisional capacity for both the participant (a11 = 0.328, p = 0.005) and the CP (a22 = 0.262, p = 0.025). CP’s level of MCI/AD knowledge had a negative association for partner effects for decisional capacity (p21 = ‐0.207, p = 0.043) of the PwMCI.ConclusionAssessment of decisional capacity is imperative when considering participation in AD research, including biomarker studies involving results disclosure. Our findings highlight that not only do individual characteristics put PwMCI at risk for lower decisional capacity, but dyadic effects from their CPs may also be present.

Psychosocial impact of being diagnosed with mild cognitive impairment: patient and carer perspective.

Mild cognitive impairment (MCI) may represent an intermediate, prodromal phase of dementia. Although persons with MCI (PwMCI) are able to function independently, they often experience reduced ability to carry out their usual activities. This can result in social, emotional and functional challenges. To explore the understanding and psychosocial impact of receiving a diagnosis of MCI on patients and carers. A cross-sectional cohort study was conducted at St James's Hospital Memory Clinic involving patients who attended the clinic for assessment from 1 January 2020 to 30 April 2021 and received a diagnosis of MCI. We completed questionnaires with patients and a nominated family member or friend of each patient (FwMCI). Forty-seven PwMCI participated in the study, and 36 nominated family members and/or friends completed the FwMCI questionnaire. In our cohort of PwMCI, most of the participants were not aware of their diagnosis; only 21% used the term MCI, and only 25% attributed their problems to a pathological cause. The majority of participants had no recollection of any discussion around the likelihood of progression. One-third of participants expressed relief that they did not have dementia. Most PwMCI reported positive psychological well-being and did not endorse symptoms of depression or anxiety. There was slight discordance of illness perception among the PwMCI-FwMCI dyads. Forty-seven per cent of FwMCI reported at least a mild degree of carer burden on the Zarit Burden Scale. Patients' awareness of being diagnosed with MCI is relatively limited. Public education campaigns raising awareness about MCI can help influence the 'illness representation' for MCI and enable people to seek timely advice and support.

Short Term Economic Evaluation of the Digital Platform "Support, Monitoring and Reminder Technology for Mild Dementia" (SMART4MD) for People with Mild Cognitive Impairment and their Informal Caregivers.

Background:A randomized controlled trial of the SMART4MD tablet application was conducted for persons with mild cognitive impairment (PwMCI) and their informal caregivers to improve or maintain quality of life.Objective:The objective was to conduct economic evaluation of SMART4MD compared to standard care in Sweden from a healthcare provider perspective based on a 6-month follow-up period.Methods:Three hundred forty-five dyads were enrolled: 173 dyads in the intervention group and 172 in standard care. The primary outcome measures for PwMCI and informal caregivers were quality-adjusted life years (QALY). The results are presented as incremental cost-effectiveness ratios, and confidence intervals are calculated using non-parametric bootstrap procedure.Results:For PwMCI, the mean difference in total costs between intervention and standard care was € 12 (95% CI: –2090 to 2115) (US$ = € 1.19) and the mean QALY change was –0.004 (95% CI: –0.009 to 0.002). For informal caregivers, the cost difference was – € 539 (95% CI: –2624 to 1545) and 0.003 (95% CI: –0.002 to 0.008) for QALY. The difference in cost and QALY for PwMCI and informal caregivers combined was –€ 527 (95% CI: –3621 to 2568) and –0.001 (95% CI: –0.008 to 0.006). Although generally insignificant differences, this indicates that SMART4MD, compared to standard care was: 1) more costly and less effective for PwMCI, 2) less costly and more effective for informal caregivers, and 3) less costly and less effective for PwMCI and informal caregivers combined.Conclusion:The cost-effectiveness of SMART4MD over 6 months is inconclusive, although the intervention might be more beneficial for informal caregivers than PwMCI

An Integrative Framework to Guide Social Engagement Interventions and Technology Design for Persons With Mild Cognitive Impairment.

Social isolation and loneliness in older adults are associated with poor health outcomes and have been linked to an increased risk of cognitive impairment and incident dementia. Social engagement has been identified as a key factor in promoting positive health behaviors and quality of life and preventing social isolation and loneliness. Studies involving cognitively healthy older adults have shown the protective effects of both in-person and technology-based social engagement. However, the benefits of social engagement for people who are already at-risk of developing dementia, namely those with mild cognitive impairment (MCI), have yet to be elucidated. We present a narrative review of the literature, summarizing the research on social engagement in MCI. First, we identified social networks (quality, size, frequency, and closeness) and social activities (frequency, format, purpose, type, and content) as two overarching dimensions of an integrative framework for social engagement derived from literature examining typical cognitive aging. We then used this framework as a lens to examine studies of social engagement in MCI to explore (i) the relationship between in-person and technology-based social engagement and cognitive, emotional, and physical health, and (ii) interventions that target social engagement including technology-based approaches. Overall, we found that persons with MCI (PwMCI) may have different levels of social engagement than those experiencing typical cognitive aging. Moreover, in-person social engagement can have a positive impact on cognitive, emotional, and physical health for PwMCI. With respect to activity and network dimensions in our framework, we found that cognitive health has been more widely examined in PwMCI relative to physical and emotional health. Very few intervention studies have targeted social engagement, but both in-person and technology-based interventions appear to have promising health and well-being outcomes. Our multidimensional framework of social engagement provides guidance for research on characterizing the protective benefits of social engagement for PwMCI and informs the development of novel interventions including technology-based approaches.

Effects of dyadic discrepancy in awareness of mild cognitive impairment on changes in care partner’s burden over time

Objectives:This study explored interpersonal aspects of coping with mild cognitive impairment (MCI), focusing on how shared illness representations between persons with MCI (PwMCI) and their care partners (CPs) are associated with CP perceived burden. Method:Longitudinal data from a purposive sample of 69 MCI care dyads were analyzed using descriptive statistics, t-tests, intraclass correlations, and regression analyses. Results: CP perceived their PwMCI’s deficits in MCI-related functions as more negative than PwMCI rated themselves, but the extent of the discrepancy varied across cognitive and behavioral abilities. The discrepancy in dyadic appraisal of PwMCI functioning was associated significantly with CP burden. Conclusion: The findings highlight the value of shared PwMCI and CP perspectives on cognitive functioning for MCI management and psychological adjustment.

Illness perceptions and affective symptoms: Predictors of self‐management behaviors in mild cognitive impairment

AbstractBackgroundAlthough a recent guideline on mild cognitive impairment (MCI) recommends non‐pharmacological interventions (i.e., self‐management behaviors such as exercise and cognitive training) for the management of MCI, predictors of such behaviors have not been identified in this population. We explored predictors of four categories of self‐management behaviors (i.e., physical activity, cognitive‐enhancing medication, mental activity, and vitamin/herbal supplements) in persons with MCI (PwMCI).MethodsUsing a cross‐sectional design, we conducted a secondary analysis pooling two existing datasets. We examined the predictive role of perceptual factors (i.e., individuals’ perceived understanding of MCI and its cause), affective symptoms (i.e., anxiety and depression), and clinical/sociodemographic factors. We also measured the total number of (range: 0‐4), and performance of each (‘yes’ or ‘no’) of the four categories of self‐management behaviors. We performed hierarchical linear (for the total number of self‐management behaviors) and binary logistic (for each self‐management behavior) regression analyses, controlling for age, sex, years of education, and the number of comorbid conditions as potential covariates.ResultsParticipants (N=137) were on average 71.5 years old with 16.1 years of education. Most were Caucasian (92.0%) and diagnosed with amnestic MCI (82.5%). Although we did not find any main effects of predictors, some interactions were significant through further model expansion. Better performance of self‐management behaviors was associated with 1) lower levels of perceived understanding of MCI in men (b= ‐0.090, =.037), and 2) lower levels of anxiety symptoms in Caucasian participants (b= ‐0.206, p=.049). In hierarchical logistic regression analyses, higher levels of perceived understanding of MCI were associated with the better performance of physical (OR=0.942, 95%CI=[0.898, 0.980]) and mental (OR=0.959, 95% CI=[0.922,0.998]) activities among participants with lower levels of education. Among participants with more years of education, higher levels of perceived understanding of MCI were associated with better adherence to cognitive‐enhancing medication (OR=1.043, 95% CI=[1.002, 1.085]), and more anxiety symptoms were associated with better performance of mental activity (OR=1.048, 95% CI=[1.003,1.095]).ConclusionOur findings suggest that perceived understanding of MCI, levels of anxiety, and demographic factors should be considered together when evaluating the performance of self‐management behaviors to prevent or delay further cognitive changes among PwMCI.

Characterising spoken responses to an intelligent virtual agent by persons with mild cognitive impairment

ABSTRACT The diagnosis of Mild Cognitive Impairment (MCI) characterises patients at risk of dementia and may provide an opportunity for disease-modifying interventions. Identifying persons with MCI (PwMCI) from adults of a similar age without cognitive complaints is a significant challenge. The main aims of this study were to determine whether generic speech differences were evident between PwMCI and healthy controls (HC), whether such differences were identifiable in responses to recent or remote memory questions, and to determine which speech variables showed the clearest between-group differences. This study analysed recordings of 8 PwMCI (5 females, 3 males) and 14 HC of a similar age (8 females, 6 males). Participants were recorded interacting with an intelligent virtual agent: a computer-generated talking head on a computer screen which asks pre-recorded questions when prompted by the interviewee through pressing the next key on a computer keyboard. Responses to recent and remote memory questions were analysed. Mann–Whitney U tests were used to test for statistically significant differences between PwMCI and HC on each of 12 speech variables, relating to temporal characteristics, number of words produced and pitch. It was found that compared to HC, PwMCI produce speech for less time and in shorter chunks, they pause more often and for longer, take longer to begin speaking and produce fewer words in their answers. It was also found that the PwMCI and HC were more alike when responding to remote memory questions than when responding to recent memory questions. These findings show great promise and suggest that detailed speech analysis can make an important contribution to diagnostic and stratification systems in patients with memory complaints.

PREDICTORS OF INSOMNIA IN INDIVIDUALS WITH MILD COGNITIVE IMPAIRMENT

Insomnia is a common disorder that affects up to 40% of people age 65 and older. Untreated insomnia can decrease quality of life, increase healthcare use, and exacerbate cognitive problems. Individuals with cognitive impairment experience more sleep disorders than those without cognitive concerns, yet little is known about insomnia and mild cognitive impairment (MCI). Our objective was to examine predictors of insomnia in persons with MCI (PwMCI). Using data from the National Alzheimer’s Coordinating Center Uniform Data Set, a cross-sectional study of older PwMCI was conducted. Independent sample t-tests and contingency tables with chi-square tests of independence were used to examine differences between PwMCI with and without insomnia. Multivariate binary logistic modeling was performed. The total sample (N=1543) was comprised of 234 (15.1%) with clinician-reported insomnia and 1309 (84.9%) without insomnia. PwMCI and insomnia were more likely to be younger, take more medications, and smoke cigarettes (p.05). Three variables significantly predicted insomnia in PwMCI subjects in a multivariate model: active depression (OR 1.66, 95%CI 1.21, 2.27), active anxiety (OR 2.16, 95%CI 1.57, 2.99) and arthritis (OR 1.78, 95%CI 1.33, 2.39). Differences in predictors of insomnia in PwMCI highlight the need for geriatric and mental health specialists to provide specialized care to this population. Future studies should examine conversion of PwMCI with insomnia to dementia and the compounding effects of insomnia on cognition.

DIFFERENCES IN ILLNESS PERCEPTIONS BETWEEN PARTICIPANTS WITH MILD COGNITIVE IMPAIRMENT AND THEIR CARE PARTNERS

At diagnosis, persons with mild cognitive impairment (PwMCI) and their care partners can receive information that can lead individuals to over or underestimate the significance of MCI as a potential precursor to dementia. Understanding how PwMCI and their care partners perceive the illness can help guide these challenging discussions. The purpose of this secondary analysis was to compare illness perceptions (IPs) between PwMCI and their care partners. This cross-sectional study examined baseline illness perceptions between PwMCI and care partners participating in an RCT examining the impact of disclosing amyloid PET results. IPs were measured by the Brief Illness Perception Questionnaire (B-IPQ). Repeated measures ANOVA/MANOVA was performed to examine within-dyad differences. Sixty-eight dyads were comprised of mostly male PwMCI (62.7%) and female care partners (77.9%). PwMCI tended to be older and more educated than their care partner (ps=.001). Overall B-IPQ scores differed across PwMCI and care partner (Mean=54.12 vs. 50.10, p=.039). When the set of B-IPQ dimensions were examined multivariately across PwMCI and their care partners, PwMCI’s IPs were different than care partner’s IPs (p<.001). Examination of the eight individual dimensions revealed only a difference in control, where PwMCI perceived MCI to be more within their personal control (Mean=5.73) than their care partner (Mean=2.86, p<.001). PwMCI perceive a more threatening view of MCI, however, with a greater sense of control than their care partners. Interventions encouraging dyads to explore differing perceptions of MCI may promote shared decision making, planning ahead, and, ultimately, improve dyadic well-being.

Can Transcranial Direct-Current Stimulation Alone or Combined With Cognitive Training Be Used as a Clinical Intervention to Improve Cognitive Functioning in Persons With Mild Cognitive Impairment and Dementia? A Systematic Review and Meta-Analysis.

Background: Transcranial direct-current stimulation (tDCS) facilitates cognitive improvement in healthy and pathological populations. It has been increasingly used in cases of mild cognitive impairment (MCI) and dementia. Our research question is: Can tDCS serve as a clinical intervention for improving the cognitive functions of persons with MCI (PwMCI) and dementia (PwD)?Objective: This systematic review evaluated the evidence to determine the efficacy of tDCS in improving cognitive outcomes in PwD and PwMCI.Methods: A systematic review was conducted of studies published up to November 2017 involving tDCS in cases of MCI and dementia. Studies were ranked according to the level of evidence (Oxford Center for Evidence-Based Medicine) and assessed for methodological quality (Risk of Bias Tool in the Cochrane Handbook for Systematic Reviews of Interventions). Data was extracted on all protocol variables to establish a reference framework for clinical interventions. Different modalities, tDCS alone or combined with cognitive training, compared with sham tDCS were examined in both short and long-term effects. Four randomized control trials (RCTs) with memory outcomes were pooled using the fixed-effect model for the meta-analysis.Results: Twelve studies with 195 PwD and four with 53 PwMCI met the inclusion criteria. Eleven articles were ranked as Level 1b. The results on the meta-analysis on pooled effects of memory indicated a statistically significant medium effect size of 0.39 (p = 0.04) for immediate effects. This improvement was not maintained in the long term 0.15 (p = 0.44).Conclusion: tDCS improves memory in PwD in the short term, it also seems to have a mild positive effect on memory and language in PwMCI. However, there is no conclusive advantage in coupling tDCS with cognitive training. More rigorous evidence is needed to establish whether tDCS can serve as an evidence-based intervention for both populations.

The effects of holistic health group interventions on improving the cognitive ability of persons with mild cognitive impairment: a randomized controlled trial.

PurposePersons with mild cognitive impairment (PwMCI) are at a higher risk of developing dementia than those without cognitive impairment. This research study aims to evaluate the effectiveness of a holistic health group intervention, which is based on the holistic brain health approach as well as an Eastern approach to health care, on improving the cognitive ability of Chinese PwMCI.Research methodsIn a randomized controlled trial (RCT), 38 Chinese PwMCI were randomly assigned to either a 10-session holistic health intervention group or the control group. The holistic health treatment group attempted to promote the acceptance of their illness, enhance memory and coping skills, develop a positive lifestyle, maintain positive emotions, and facilitate emotional support among participants. The 10-session holistic health group intervention was structured, with each session conducted once per week and ~90 minutes in length. Control group patients and their family caregivers received standardized basic educational materials that provided basic information on cognitive decline for them to read at home. The Montreal Cognitive Assessment (MoCA) test was used to assess the cognitive ability of PwMCI in the pre- and posttreatment periods by a research assistant who was blind to the group assignment of the participants.ResultsThe paired-samples t-test indicated that the treatment group (n=18) showed significant improvement in the MoCA score, whereas the control group (n=20) did not. Moreover, 2×2 (group × time) repeated-measures analysis of covariance (ANCOVA) demonstrated that the holistic health group treatment was significantly more effective than the control intervention in improving the MoCA score, with a moderate effect size, and improving the delayed recall (ie, short-term memory), with a strong effect size, after controlling for age, sex, education, and marital status.ConclusionThis present RCT provides evidence to support the feasibility and effectiveness of the holistic health group intervention in improving the cognitive and short-term memory abilities of PwMCI.

Deficits awareness in persons with mild cognitive impairment and family care partners.

An emerging perspective of dyadic coping with chronic illness argues that concordance in the appraisal of illness is crucial for collaborative attempts at seeking information, making treatment decisions, and planning for long-term management of the illness and psychological and physical adjustments of both the care provider and care recipient. The present study examined whether persons with mild cognitive impairment (PwMCIs) and their family care partners (CPs) exhibited concordance in their awareness of deficits in the PwMCIs. Furthermore, this study explored the differences in concordance based on the relationship of the informant to the PwMCI, specifically spouse CP (SCP) versus adult child CP (ACCP). PwMCI-SCP pairs (n = 55) and PwMCI-ACCP (n = 14) pairs provided reports on their awareness of PwMCI's functional and cognitive deficits. CPs also reported their knowledge about dementia. SCPs, but not ACCPs, reported greater deficits in everyday activity than PwMCIs' self-reports. Additionally, compared to SCPs, ACCPs had more accurate knowledge about dementia, and their perception of PwMCI deficits corresponded more closely to PwMCI's self-perception. These findings demonstrate that concordance in awareness of PwMCI deficits varies across functional and cognitive areas and types of dyads. The results also highlight the importance of mild cognitive impairment-related education and support programs for care dyads to strengthen concordance, which is likely an important underpinning for effective coping as the illness progresses. (PsycINFO Database Record

Satisfaction With a Family-Focused Intervention for Mild Cognitive Impairment Dyads.

This article describes satisfaction that persons with mild cognitive impairment (PwMCI) and their caregivers had with the Daily Enhancement of Meaningful Activity (DEMA) intervention. This randomized controlled pilot study compared satisfaction (usefulness, ease of use, and acceptability) with DEMA (n = 17 dyads) to an information support (IS) control group (n = 19 dyads). Six biweekly sessions (two in person and four by telephone) were delivered by trained nurses. Data analysis included descriptive statistics, independent-sample t tests, and content analysis. PwMCI receiving DEMA rated their satisfaction significantly higher (p = .033) than did the control group; there was no difference in satisfaction between caregivers across groups. Qualitative interview data supported the usefulness, ease of use, and acceptability of DEMA for both PwMCI and caregivers. Results documented PwMCI's satisfaction with DEMA as implemented by nurses to support PwMCI-caregiver dyads' engagement in meaningful activity. DEMA may need revision to increase satisfaction for caregivers. The DEMA intervention was evaluated as useful, easy to use, and acceptable to PwMCI and their caregivers based on positive mean ratings. The study findings provide preliminary support of DEMA as a means to improve quality of life by helping to support patient and caregiver engagement in meaningful activities and problem solving.

Dyadic Analysis of Illness Perceptions Among Persons with Mild Cognitive Impairment and Their Family Members.

To characterize illness perceptions among persons with mild cognitive impairment (PWMCI) and their family care partners, and to examine whether PWMCI's and their family care partners' illness perceptions were associated with their own, as well as the other member of the dyad's, emotional reactions to MCI. This cross-sectional study of PWMCI and their family care partners (n = 60 dyads) used patient and relative versions of the Revised Illness Perception Questionnaire (IPQ-R) to assess metacognitive and emotional features of illness perception in MCI along 5 dimensions of perceived: seriousness of potential consequences, personal controllability, timeline, fluctuation (cycling) of symptoms, and illness coherence (clear vs. confusing). As compared to family members, PWMCI perceived MCI to be less potentially serious and to be more within their personal control, but dyads otherwise shared similar perceptions of MCI. Among PWMCI, perceived seriousness of the potential consequences of MCI was the only dimension to be significantly correlated with emotional distress. For family members, increased MCI-related emotional distress was significantly associated with perceptions of MCI as potentially serious, permanent, or confusing. A dyadic analysis using APIM showed that MCI-related emotional distress, in both PWMCI and family members, was linked to the PWMCI's perception of the seriousness of MCI. MCI-related education and support should be tailored for both the PWMCI and family member audiences, while acknowledging interdependence of illness perceptions within family units. Tailored information and support will be critical in managing MCI going forward, as illness perceptions are likely key factors on which individuals will plan for the future or base medical decisions.

Content validity and acceptability of the daily enhancement of meaningful activity program: intervention for mild cognitive impairment patient-spouse dyads.

Persons with mild cognitive impairment (PwMCI) are at greater risk for developing Alzheimer disease and experience various difficulties that decrease their quality of life. Very few interventions focus on helping PwMCI improve or maintain functional performance and enhance quality of life through meaningful activity engagement. The purpose of the study was to explore PwMCI and their spouses' perspectives on the content validity, usefulness, and acceptability of the Daily Enhancement of Meaningful Activity (DEMA) program, which included 6 biweekly face-to-face sessions between session assignments and a self-management tool kit of written educational handouts. Nine PwMCI-care partner dyads participated in 3 focus groups (PwMCI alone, spouses alone, and couples) to capture their perspectives on DEMA. The transcribed focus group data were analyzed through content analysis. The three groups provided support for content validity and acceptability of the program, and they suggested additional content areas important to couples experiencing MCI. They also attested to the usefulness of the tool kit and gave suggestions for its further improvement. The findings provide evidence of the content validity and acceptability of the DEMA program. A pilot study to assess feasibility and preliminary efficacy of the DEMA on health-related outcomes is the recommended next research step for this program.

Long Term Caregiving: Helping Families of Persons with Mild Cognitive Impairment Cope

The purpose of the paper is to describe common psychological and caregiving issues that can cause stress in family members of persons with mild cognitive impairment (PwMCI) in order to assist family members in providing care and support to the PwMCI while also caring for themselves over long periods of time. Because PwMCI and their family members have time to prepare for the future should the PwMCI no longer be able to participate in their own care, it is important that clinicians offer support, education, and referrals for services and interventions when needed. The results of a review and synthesis of the caregiving literature found that much information exists from educational and intervention programs designed to help caregivers of Alzheimer disease however little empirical information is available for clinicians to assist PwMCI and their family members. This paper provides valuable and practical information for clinicians and other care providers to assist family members of PwMCI to cope with the uncertainty of the diagnosis, prepare for the future, and manage their stress over the long-term.

Perceptions of Illness, Coping, and Well-being in Persons With Mild Cognitive Impairment and Their Care Partners

Despite greater attention to mild cognitive impairment (MCI), little is known about reactions to this potentially threatening diagnosis among persons with MCI (PWMCI) and their care partners. Psychologic reactions, perceptions of illness, and coping responses of 46 individuals recently diagnosed with MCI and 29 care partners were assessed with questionnaires assessing psychologic well-being, illness perceptions, coping, and perceived needs for services. Care partners and PWMCI report normal levels of psychologic well-being, showing less distress than is commonly found in Alzheimer disease (AD) caregivers. Problem-focused (eg, active coping) and emotion-focused coping strategies (eg, acceptance) were used more often than dysfunctional coping strategies (eg, self-distraction) by PWMCI and care partners. Both groups tended to minimize the likelihood of conversion to AD, and endorsed mental and physical exercise, optimism, dietary changes, and stress reduction as strategies to prevent conversion. Although PWMCI minimized their impairment, care partners reported providing an average of 24 hours per week of caregiving and reported that the PWMCI did need significant help with complex activities. Respondents reported using few formal services but they anticipate substantial future need for services. Results suggest that PWMCI and care partners are likely to minimize the threat of AD and to perceive that conversion is controllable and preventable with health promotion activities. Study implications for the development of intervention programs for PWMCI and their care partners are discussed.