Self-Efficacy Mediates the Association Between Physical Function and Perceived Quality of Life in Individuals with Mild Cognitive Impairment

Abstract

Background: Research has shown that individuals with mild cognitive impairment (MCI) value quality of life (QoL) above and beyond cognitive function or other potential outcomes in MCI. There is evidence supporting the negative impact of poor physical function on QoL ratings. Objective: The study explored whether a modified measure of self-efficacy for managing MCI and education mediated and/or moderated the relationship between physical function and QoL in persons with MCI. Methods: Baseline data from 200 participants with MCI were obtained from a larger study assessing the effectiveness of a behavioral intervention. Physical function was assessed by the Short Physical Performance Battery. QoL was assessed with the Quality of Life in Alzheimer's Disease scale. Memory-related self-efficacy was assessed using a modified 9-item version of the Chronic Disease Self-Efficacy Scales. Mediation and moderation analyses tested the hypotheses that self-efficacy and education alter the association between physical function and QoL in individuals with MCI. All analyses were adjusted for age, cognitive severity, and sex. Results: Self-efficacy for managing MCI was a significant mediator of the association between physical function and perceived QoL. Individuals with better physical function reported higher self-efficacy which was associated with higher QoL ratings. Conclusions: Greater self-efficacy for managing MCI mediated the negative association between physical function and quality of life in this exploratory study. Interventions aimed at enhancing memory self-efficacy in MCI may improve perceived QoL, even in the presence of poor physical function. Future research is needed to investigate this further.

"Non-Pharmacological Interventions that Improve Quality of Life in People with Mild Cognitive Impairment"

“…QOL was positively associated with self-efficacy, extraversion personality trait, and agreeableness personality trait, daily life functions, social net, work size, spatial cognition capabilities, and negatively associated with memory complaints, depressive symptoms, and neuroticism personality traits. A survey study showed self-efficacy as a mediator between physical function and perceived QOL in individuals with MCI [28]. However, another correlational study found that anxiety and depression partially mediated the effect of self-efficacy on QOL in people with MCI or dementia, with depression showing a medium mediation effect (b = 0.32, 95% CI = [0.23, 0.47]) [29].…”

Psychometric properties of the self‐efficacy for managing mild cognitive impairment scale

“…For example, a person may have significant physical limitations that keep them from walking independently, yet their sense of self‐efficacy to achieve their daily chores independently is high due to adaptive strategies or devices they know how to use to compensate. In our own research, evidence supported higher self‐efficacy attenuated the effect of physical decline on QoL 14 . As part of our efforts to study the impact of MCI behavioral interventions, 12,13,20,21 we adapted a self‐efficacy measure for managing chronic illness 22 to be specific to pwMCI.…”

“…In our own research, evidence supported higher self-efficacy attenuated the effect of physical decline on QoL. 14 As part of our efforts to study the impact of MCI behavioral interventions, 12,13,20,21 we adapted a self-efficacy measure for managing chronic illness 22 to be specific to pwMCI. While MCI-related changes do not significantly impede the person's ability to function independently, pwMCI can experience changes to their daily functioning (eg, managing finances, keeping track of appointments), as well as psychological changes and changes in QoL.…”

“…In aging research, self-efficacy, particularly memory self-efficacy (memory-SE), which is defined as a person's evaluation of his/her ability to complete a given memory task with confidence, 9 are variables of interest in examining factors that may maintain cognitive, functional, and psychosocial integrity in aging. Iteratively, it may impact and be impacted by cognitive training, [10][11][12][13] physical exercise, 14 depression, 15 and QoL. 14 Studies with cognitively impaired older adults show that improving self-efficacy might reduce the impact depressive symptoms has on cognition, supporting self-efficacy as a possible target for interventions.…”

“…Iteratively, it may impact and be impacted by cognitive training, [10][11][12][13] physical exercise, 14 depression, 15 and QoL. 14 Studies with cognitively impaired older adults show that improving self-efficacy might reduce the impact depressive symptoms has on cognition, supporting self-efficacy as a possible target for interventions. 16 Another study demonstrated that self-efficacy predicted self-rated "capacity to live well" among people with dementia, even when adjusting for covariates such as age, and functional and cognitive ability.…”