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How Does Cognition Among OAs Impact Long-term Care Planning?
Working memory and inductive reasoning are essential to aging-in-place (AIP) and long-term care (LTC) decision making among older adults (OAs), according to findings published in the Journal of the American Geriatrics Society.
“This information is important as providers and families need to broach this subject and make future plans with OAs prior to loss in these cognitive areas,” wrote researchers. “Aspects of OAs cognition should be assessed at least annually and incorporated in regular exams (such as the annual Medicare wellness visit) so they can be involved in AIP-LTC decision-making as early as beginning of changes in cognitive aspect is detected.”
Deferring decisions about AIP/LTC needs is common among OAs, but when cognition worsens OAs are unable to make these important decisions for themselves.
Researchers used a cohort of 293 community-based OAs aged 65 years and older with extensive cognitive testing recruited from hospital-associated primary care clinics in Chicago, IL, to examine their decision-making. Participants were a mean age of 73 years and 40.4% non-White.
Study participants underwent baseline testing, were given a PlanYourLifespan.org (PYL) online intervention, and were surveyed about AIP-LTC decision making at 1-, 6-, and 12-month intervals.
When OAs who had adequate inductive reasoning (ETS letter sets total—OR=1.14 (95% CI=1.03-1.27; P < .05)) and adequate working memory (size judgment span total—OR=1.76 (95% CI=1.13-2.73; P < .05)) were more likely to make AIP-LTC decisions.
In terms of verbal abilities, long-term memory, or processing speed, researchers did not observe any differences in decision-making.
“Screening routinely for these specific cognitive domains is important in targeting and helping older adults prepare in time for their future AIP-LTC needs,” concluded researchers.
Reference:
Lindquist LA, Miller-Winder AP, Schierer A, et al. Aspects of cognition that impact aging-in-place and long-term care planning. J Am Geriatr Soc. Published online June 20, 2022. doi:10.1111/jgs.17927
