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Published on: September 30, 2020
Frequency and correlates of advance planning among cognitively impaired older adults
Jennifer Hagerty Lingler1, Karen B Hirschman, Linda Garand
1Department of Health and Community Systems, University of Pittsburgh, Pittsburgh, PA, USA. linglerjh@upmc.edu
Objective:
To examine the prevalence and sociodemographic correlates of written advance planning among patients with or at risk for dementia-imposed decisional incapacity.
Design:
Retrospective, cross-sectional.
Setting:
University-based memory disorders clinic.
Participants:
Persons with a consensus-based diagnosis of mild cognitive impairment (N = 112), probable or possible Alzheimer disease (AD; N = 549), and nondemented comparison subjects (N = 84).
Intervention:
N/A.
Measurements:
Semistructured interviews to assess durable power of attorney (DPOA) and living will (LW) status upon initial presentation for a dementia evaluation.
Results:
Sixty-five percent of participants had a DPOA and 56% had a LW. Planning rates did not vary by diagnosis. European Americans (adjusted odds ratio = 4.75; 95% CI, 2.40-9.38), older adults (adjusted odds ratio = 1.05; 95% CI, 1.03-1.07) and college graduates (adjusted odds ratio = 2.06; 95% CI, 1.33-3.20) were most likely to have a DPOA. Findings were similar for LW rates.
Conclusions:
Although a majority of persons with and at risk for the sustained and progressive decisional incapacity of AD are formally planning for the future, a substantial minority are not.
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