scholarly journals Decision-Making Support for People With Alzheimer’s Disease: A Narrative Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Weiyi Sun ◽  
Teruyuki Matsuoka ◽  
Jin Narumoto
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Decision Making ◽  
External Factors ◽  
Narrative Review ◽  
Medical Decision ◽  
Financial Industry ◽  
Decision Making Capacity ◽  
Internal And External Factors ◽  
Decision Making Support

The proportion of people with dementia has been increasing yearly, and the decision-making capacity of these people has become a major concern in fields such as the financial industry and in medical settings. In this narrative review, we discuss decision-making in people with Alzheimer’s disease (AD), and we propose the support for decision-making in people with AD, especially financial and medical decision-making. We summarize several hypotheses and theories on the decision-making capacity of people with AD. These include the frontal lobe hypothesis, physiological theory, dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, and the Person-Task-Fit (PTF) framework. Both internal and external factors can affect decision-making by people with AD. Internal factors are affected by changes in the brain and neurotransmitters, as well as alterations in cognitive ability and emotion. External factors include task characters, task contents, and situation influence. Since feedback has a significant effect on decision-making capacity, a series of suggestions may be helpful to improve this capacity, such as explicit advice, simple options, pleasant rewards, the Talking Mats approach, memory and organizational aid, support by caregivers, cognitive training and feedback. Thus, in providing decision-making support for people with AD, it is important to identify the internal and external factors that impair this process and to deal with these factors.

Do adapted vignettes improve medical decision-making capacity for individuals with Alzheimer's disease?

2017 ◽  
Vol 58 (6) ◽  
pp. 497-503 ◽  
Author(s):  
Liv Thalén ◽  
Katarina Heimann Mühlenbock ◽  
Ove Almkvist ◽  
Maria Eriksdotter ◽  
Erik Sundström ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Decision Making ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Decision Making Capacity

Decisions and attitudes regarding participation and proxy in clinical trials among patients with impaired cognitive function

Dementia ◽  
2017 ◽  
Vol 18 (6) ◽  
pp. 2049-2061
Author(s):  
S Stormoen ◽  
IM Tallberg ◽  
O Almkvist ◽  
M Eriksdotter ◽  
E Sundström
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Decision Making ◽  
Clinical Trials ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
High Risk ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Decision Making Capacity

Background Medical decision-making capacity is impaired in Alzheimer’s disease and mild cognitive impairment. Medical decision-making capacity depends on many different cognitive functions and varies due to situation and cognitive, social, and emotional status of the patient. Our aim was to analyze dementia patients’ capacity to estimate risks and benefits in different clinical trials and determine how cognitive decline affects their attitude toward possible participation and proxy consent. Methods Groups: Alzheimer’s disease (n = 20), mild cognitive impairment (n = 21) and healthy controls (n = 33). Two hypothetical clinical trials, a standardized interview and three visual analogue scales were used to investigate decisions, estimations, reasoning, and attitudes. Results A general positive attitude toward participation in clinical trials was shown among all groups. Both patients and controls motivated possible participation as “own-benefit” in the low-risk trial and to “help-others” in the high-risk trial. Individuals who accepted to participate in the high-risk trial scored lower in medical decision-making capacity in comparison to participants who would not have participated (p < .01). Patients in the Alzheimer’s disease but not mild cognitive impairment and healthy control groups underestimated risks and overestimated benefits in the high-risk/low-benefit trial (p < .05). A family member was most frequently chosen as possible proxy (91%). Conclusions Medical decisions and research consent should be interpreted with caution in patients who are already in early stages of dementia, as the patients’ acceptance to participate in high-risk trials may be due an insufficient decisional capacity and risk analysis, accelerated by a general desire to make good to society. We emphasize the use of a standardized tool to evaluate medical decisional capacity in clinical research.

P1-148 Declining medical decision-making capacity in Alzheimer's disease: a two-year longitudinal study

2004 ◽  
Vol 25 ◽  
pp. S137-S138
Author(s):  
Daniel C. Marson ◽  
Justin Huthwaite ◽  
Roy Martin ◽  
Randall Griffith ◽  
Britt Anderson ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Decision Making ◽  
Longitudinal Study ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Decision Making Capacity

scholarly journals The Relationship Between Dementia Severity & Caregiver Preferences for Decision Making Role Regarding Mammography

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 992-992
Author(s):  
Molly Frank ◽  
Seho Park ◽  
Kathleen Lane ◽  
Alexia Torke ◽  
Mara Schonberg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Decision Making ◽  
Rating Scale ◽  
Medical Decision ◽  
Diagnose Breast Cancer ◽  
Dementia Severity ◽  
Increased Risk ◽  
The Relationship

Abstract The incidence of Alzheimer’s disease and related dementias (ADRD) and breast cancer increases with age. Despite being one of the most effective ways to diagnose breast cancer early, mammography in ADRD patients comes with an increased risk of treatment complications and false-positive results. Family caregivers are often involved in the decision-making process, and this study evaluates the relationship between dementia severity and caregiver preferences when making decisions about mammography with the patient alone, and with the patient and doctor. We included 181 caregivers from the Decisions about Cancer screening in Alzheimer’s Disease trial, which uses the Dementia Severity Rating Scale (DSRS) to assess dementia severity and a modified Control Preferences Scale (CPS) to assess each caregiver’s preferred decision-making approach. Multinomial logistic regression models evaluated the relationship between DSRS and CPS categories (active, passive, and collaborative), while controlling for the caregivers’ age, sex, race, education, and relationship to patient. Model 1 examined the caregivers’ preferred role with the patient, and it found a significant association between increased dementia severity and preference for a collaborative approach (p&lt;0.001) or passive approach (p&lt;0.05) compared to an active approach. Model 2 did not find a significant association between dementia severity and the caregivers’ preferred role when making decisions with the patient and doctor; however, those with increased age and education were more likely to prefer an active role. The association between dementia severity, caregiver characteristics, and decision-making preferences supports the need for approaches to support ADRD caregivers with medical decision making.

scholarly journals P4-449: Memory awareness influences everyday decision making capacity in Alzheimer's disease

2011 ◽  
Vol 7 ◽  
pp. e68-e68
Author(s):  
Stephanie Cosentino ◽  
Janet Metcalfe ◽  
Mark Cary ◽  
Jason Karlawish
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Decision Making ◽  
Decision Making Capacity ◽  
Memory Awareness
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