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Patient Preferences for Dementia Interventions: A Scoping Review With a Systematic Review of Medications and
Ravi Gupta1,2, Shanshan Lin1, Michael J DiStefano3
1Division of General Internal Medicine, Johns Hopkin School of Medicine, Baltimore, Maryland, USA.
Background:
Despite emerging treatment options for Alzheimer's disease and related dementias (ADRD), patient preferences for treatment and care remain poorly understood.
Methods:
We searched PubMed, PsycINFO, CINAHL, and EMBASE through November 12, 2024 for studies reporting stated preferences for dementia treatment- and care-related interventions. We synthesized key findings from studies using choice-based preference elicitation methods and those addressing medication preferences.
Results:
We screened 8300 abstracts and 82 studies published between 1996 and 2024 were included. Most evaluated preferences for non-pharmacological interventions. Studies were experimental (37; 45.1%), observational (36; 43.9%), and qualitative (21; 25.6%). Six studies used choice-based preference elicitation methods and five assessed preferences for medications. Patients valued memory improvement and emotional or social support, despite highly heterogeneous data.
Conclusions:
This review highlights significant gaps in the literature on treatment preferences-particularly for medications-among older adults with cognitive impairment, underscoring the need for further research, development of validated clinical tools, and appropriate methods to elicit preferences to better align interventions with patient values.
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