Navigating memory problems and mild cognitive impairment in later life: A qualitative secondary data analysis

Many people experience memory concerns as they get older, which can produce uncertainty and confusion. Some seek help for memory concerns and receive diagnoses of Mild Cognitive Impairment or Subjective Cognitive Decline, while most do not. We aimed to explore the subjective experiences of people with cognitive concerns, and how memory impairment is understood in the context of ageing. We undertook a secondary data analysis of 18 in-depth semi-structured interviews with people aged 60+ living with memory concerns, 9 of whom had sought professional help. We thematically analysed the data, identifying three themes. 1. <i>Situating Memory Concerns</i>: people are required to situate their experiences within contradictory discourses: medicalised, diagnostic categories, and reassurances that symptoms are normal, part of ageing and distinct from dementia. 2. <i>Affirming self in the face of memory loss:</i> individuals refer to social roles in families, work, and associated activities to reaffirm identity. For some, activities were a vital anchor of identity, resulting in negative self-comparison to their past self if abilities declined. 3<i>. Maintaining</i> identity <i>and Relationships;</i> labelling memory concerns helped relatives seeking external validation of symptoms, but not the person experiencing them, for whom it brought no additional support. Consequently, some participants concealed memory concerns. We concluded that the subjective experiences of people with memory concerns were characterised by confusion, and diagnostic labels compounded this rather than offering reassurance, bringing tension to some relationships. Activities were often perceived as an outward sign of continuing identity, leading to distress when ability to continue them declined. We discuss these issues in relation to broader societal issues around age and ageing.