The Moderating Roles of Social Support, Coping Resources and Personality and Mediating Role of Self-esteem on the Impact of Cognitive Deficit on Neuropsychiatric Symptoms Among Persons With Mild Cognitive Impairment: A Mixed-method Sequential Explanatory Design

This is a sequential mixed study to test the hypothesized models with seven hypotheses of the relationship between cognitive deficit (subject and objective) and neuropsychiatric symptoms (NPS) among persons with mild cognitive impairment (PwMCI). The study will also examine the psychometric properties of the Chinese version of Mild Behavioural Impairment -Checklist (MBI-C).

The primary aim of this study is to test the hypothesized model that explores the moderating roles of neurotic personality, social support and coping style, as well as the mediating role of self-esteem in the relationship between cognitive deficit and NPS. This study will also examine the psychometric properties of the Chinese version of MBI-C.

Specifically, the four objectives of this study are as follows:

1. To examine the relationship between cognitive deficit (subjective and objective) and NPS
2. To examine the moderating roles of the neurotic trait (neuroticism) and coping resources (coping style and social support), as well as the mediating role of self-esteem in the relationship between cognitive deficit and NPS
3. To explore the life experience of PwMCI that help to determine how these factors moderate/ mediate the relationship between cognitive deficit and NPS
4. To examine the psychometric properties of the Chinese version of MBI-C among PwMCI in Hong Kong

This sequential mixed study will be conducted in two non-governmental organization in Hong Kong.

For the first and second objective, a descriptive, cross-sectional, correlational approach will be adopted to test the hypothesized models with seven hypotheses of the relationship between cognitive deficit (subject and objective) and NPS. The moderating roles of personality trait (neuroticism) and coping resources (coping styles and social support), as well as the mediating role of self-esteem in such a relationship, will also be explored.

For the third objective, semi-structured interviews will be adopted to explore the life experience of PwMCI, which help understanding how the proposed factors mediate or moderate the relationship between compromised abilities and NPS.

For the fourth objective, the psychometric properties of the Chinese version of MBI-C will be examined and reported. Internal consistency, 2-week test-retest reliability, factorial validity, concurrent validity and convergent validity will be assessed.

Eligibility Criteria:
Inclusion Criteria:

* Aged 18 years old or above
* Able to communicate in Cantonese
* Diagnosis with MCI as defined by the following criteria:

  1. Presence of significant cognitive complaints, as defined by more than three complaints on the Memory Inventory for Chinese (MIC), which is a 27-item instrument measuring subjective memory deficit
  2. Abnormal objective cognitive performance defined as \< 1.5 standard deviations from age and education matched normal persons on Hong Kong Chinese version of Montreal Cognitive Assessment (HK-MoCA), which is a 12-item instrument measuring cognitive functions
  3. Independence in daily living as evaluated through clinical interview
* Both patients and one of their guardian or family members are consented to participate in the study

Exclusion Criteria:

* With the confirmed diagnosis of any forms of dementia
* With the confirmed diagnosis of psychiatric morbidities, or history with stroke, brain injury and other neurological conditions that may affect cognitive, behavioural and emotional functioning which may confound outcome measurement and limit their participation in the study
* With hearing or visual impairment that may hinder participation in research activities
* Current use of cognitive intervention or electromagnetic stimulation