Everyday decision-making ability in older persons with cognitive impairment

Area of Science:

• Neuroscience
• Psychology
• Gerontology

Background:

• Assessing decision-making capacity is crucial for individuals with cognitive impairment.
• Existing tools may not fully capture the nuances of everyday decision-making.
• The Assessment of Capacity for Everyday Decision-Making (ACED) was developed to address this gap.

Purpose of the Study:

• To establish the reliability and validity of the ACED instrument.
• To evaluate its effectiveness in assessing everyday decision-making skills.

Main Methods:

• The ACED was administered to 39 individuals with cognitive impairment and 13 cognitively intact caregivers.
• Reliability was assessed using intraclass correlation coefficients and Cronbach's alpha.
• Validity was examined through correlations with established measures of decision-making capacity and cognitive function.

Main Results:

• The ACED demonstrated good reliability for understanding, appreciation, and reasoning.
• Cronbach's alpha coefficients were >=0.84 for all decision-making abilities.
• The ACED showed moderate to strong correlations with the MacArthur Competency Assessment Tool for Treatment and overall cognition measures.

Conclusions:

• The ACED is a reliable and valid instrument for assessing decision-making capacity.
• It can be a valuable addition to existing methods for evaluating everyday decision-making.
• The findings support the ACED's utility in clinical and research settings.