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Advance directives among cognitively impaired persons who had an amyloid PET scan and their care partners: a mixed-methods study.

Publication ,  Journal Article
Bélanger, E; Couch, E; Carroll, MS; DePasquale, N; Gadbois, EA; Shepherd-Banigan, M; Jutkowitz, E; Van Houtven, CH; Plassman, BL; Wetle, TT
Published in: BMC Palliat Care
November 6, 2022

BACKGROUND: Little research exists on the role of β-amyloid PET scans as part of Alzheimer's diagnostic tests and documentation of end-of-life preferences for persons with cognitive impairment. The study objectives were to examine the association of amyloid PET scan results (elevated vs. not elevated amyloid levels) and diagnostic category (mild cognitive impairment vs. dementia) with the likelihood of having an advance directive (reported a median of 4.5 months post-scan); to explore perceptions of PET scan results and their influence on planning for the future among persons with cognitive impairment and their care partners. METHODS: Sequential, explanatory mixed-methods design using data from dyads in the CARE-IDEAS study: advance directives as a factor of diagnostic category and scan result using multivariable logistic regression models; thematic analysis of semi-structured interviews with persons with cognitive impairment and care partners to explore how scan results influenced documentation of future healthcare preferences. Participants included 1784 persons with cognitive impairment and care partners from the CARE-IDEAS study, and a subsample of 100 semi-structured telephone interviews. RESULTS: 81.6% of dyads reported an advance directive. Non-Hispanic, White participants had higher rates of advance directives. There was no significant association between having an advance directive and scan results. Qualitative analysis provided insight into perceived urgency to have advance directives, evolving healthcare preferences, and the context of completing advance directives. CONCLUSIONS: Although amyloid PET scans prompted persons with cognitive impairment and care partners to consider progressive cognitive impairment as part of evolving healthcare preferences, we found substantial variability in the perceived urgency of documentation.

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Published In

BMC Palliat Care

DOI

EISSN

1472-684X

Publication Date

November 6, 2022

Volume

21

Issue

1

Start / End Page

194

Location

England

Related Subject Headings

  • Positron-Emission Tomography
  • Humans
  • Gerontology
  • Delivery of Health Care
  • Cognitive Dysfunction
  • Caregivers
  • Advance Directives
  • 4205 Nursing
  • 4203 Health services and systems
  • 1117 Public Health and Health Services
 

Citation

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Bélanger, E., Couch, E., Carroll, M. S., DePasquale, N., Gadbois, E. A., Shepherd-Banigan, M., … Wetle, T. T. (2022). Advance directives among cognitively impaired persons who had an amyloid PET scan and their care partners: a mixed-methods study. BMC Palliat Care, 21(1), 194. https://doi.org/10.1186/s12904-022-01082-4
Bélanger, Emmanuelle, Elyse Couch, Michaela S. Carroll, Nicole DePasquale, Emily A. Gadbois, Megan Shepherd-Banigan, Eric Jutkowitz, Courtney H. Van Houtven, Brenda L. Plassman, and Terrie T. Wetle. “Advance directives among cognitively impaired persons who had an amyloid PET scan and their care partners: a mixed-methods study.BMC Palliat Care 21, no. 1 (November 6, 2022): 194. https://doi.org/10.1186/s12904-022-01082-4.
Bélanger E, Couch E, Carroll MS, DePasquale N, Gadbois EA, Shepherd-Banigan M, et al. Advance directives among cognitively impaired persons who had an amyloid PET scan and their care partners: a mixed-methods study. BMC Palliat Care. 2022 Nov 6;21(1):194.
Bélanger, Emmanuelle, et al. “Advance directives among cognitively impaired persons who had an amyloid PET scan and their care partners: a mixed-methods study.BMC Palliat Care, vol. 21, no. 1, Nov. 2022, p. 194. Pubmed, doi:10.1186/s12904-022-01082-4.
Bélanger E, Couch E, Carroll MS, DePasquale N, Gadbois EA, Shepherd-Banigan M, Jutkowitz E, Van Houtven CH, Plassman BL, Wetle TT. Advance directives among cognitively impaired persons who had an amyloid PET scan and their care partners: a mixed-methods study. BMC Palliat Care. 2022 Nov 6;21(1):194.
Journal cover image

Published In

BMC Palliat Care

DOI

EISSN

1472-684X

Publication Date

November 6, 2022

Volume

21

Issue

1

Start / End Page

194

Location

England

Related Subject Headings

  • Positron-Emission Tomography
  • Humans
  • Gerontology
  • Delivery of Health Care
  • Cognitive Dysfunction
  • Caregivers
  • Advance Directives
  • 4205 Nursing
  • 4203 Health services and systems
  • 1117 Public Health and Health Services