Advance Care Planning Among OAs With Perceived Dementia Risk

Despite the risk factor of dementia in older adults (OAs), researchers explained this population is not consistently engaging in advance care planning (ACP) but would benefit from it if the disease developed.

Study authors examined the association between perceived dementia risk and ACP participation in OAs with a goal of establishing how often they believe they are not at risk of developing the disease.

Participants included community-dwelling adults aged 65 years or older without cognitive impairment who were previously interviewed about their perceived dementia risk (n = 711) in 2016 for the Health and Retirement Study.

As part of the study, participants were asked: “On a scale of 0 to 100, what is the percent chance that you will develop dementia sometime in the future?” was used to determine perceived dementia risk. 

The association between perceived risk and discussion of treatment preferences, completion of a living will, and appointment of a durable power of attorney for health care decisions was determined based on multivariable-adjusted logistic regression.

Results showed a perceived dementia risk of 0% was reported by 10.5% of participants. “Perceived risk of 0% was associated with lower odds of completing a living will (OR 0.53; 95% CI, 0.30–0.93) and discussing treatment preferences (OR 0.51; 95% CI, 0.28-0.93) but not appointment of a durable power of attorney (OR 0.77; 95% CI, 0.42-1.39),” stated researchers.

Furthermore, ACP activities had not been completed by many participants with a greater than 0% perceived dementia risk, which included a significant minority with a greater than 50% perceived risk.

“OAs with no perceived dementia risk are less likely to participate in several forms of ACP, but the fact that many older adults with high levels of perceived risk had not completed ACP activities suggests that efforts beyond raising risk awareness are needed to increase engagement,” concluded study authors.

Reference:
Lee YK, Fried TR, Costello DM, Hadjuck AM, O’Leary JR, Cohen AB. Perceived dementia risk and advance care planning among older adults. J Am Geriatr Soc. Published online March 11, 2022. doi:10.1111/jgs.17721