Medical decision-making capacity in cognitively impaired Parkinson's disease patients without dementia.
Identifieur interne : 002223 ( PubMed/Checkpoint ); précédent : 002222; suivant : 002224Medical decision-making capacity in cognitively impaired Parkinson's disease patients without dementia.
Auteurs : Roy C. Martin [États-Unis] ; Ozioma C. Okonkwo ; Joni Hill ; H Randall Griffith ; Kristen Triebel ; Alfred Bartolucci ; Anthony P. Nicholas ; Ray L. Watts ; Natividad Stover ; Lindy E. Harrell ; David Clark ; Daniel C. MarsonSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2008.
English descriptors
- KwdEn :
- Aged, Case-Control Studies, Cognition Disorders (complications), Cognition Disorders (psychology), Decision Making (physiology), Dementia (complications), Female, Humans, Informed Consent (psychology), Informed Consent (standards), Male, Mental Competency, Middle Aged, Neuropsychological Tests, Parkinson Disease (complications), Parkinson Disease (psychology), Physician-Patient Relations, Retrospective Studies.
- MESH :
- complications : Cognition Disorders, Dementia, Parkinson Disease.
- physiology : Decision Making.
- psychology : Cognition Disorders, Informed Consent, Parkinson Disease.
- standards : Informed Consent.
- Aged, Case-Control Studies, Female, Humans, Male, Mental Competency, Middle Aged, Neuropsychological Tests, Physician-Patient Relations, Retrospective Studies.
Abstract
Little is currently known about the higher order functional skills of patients with Parkinson disease and cognitive impairment. Medical decision-making capacity (MDC) was assessed in patients with Parkinson's disease (PD) with cognitive impairment and dementia. Participants were 16 patients with PD and cognitive impairment without dementia (PD-CIND), 16 patients with PD dementia (PDD), and 22 healthy older adults. All participants were administered the Capacity to Consent to Treatment Instrument (CCTI), a standardized capacity instrument assessing MDC under five different consent standards. Parametric and nonparametric statistical analyses were utilized to examine capacity performance on the consent standards. In addition, capacity outcomes (capable, marginally capable, or incapable outcomes) on the standards were identified for the two patient groups. Relative to controls, PD-CIND patients demonstrated significant impairment on the understanding treatment consent standard, clinically the most stringent CCTI standard. Relative to controls and PD-CIND patients, PDD patients were impaired on the three clinical standards of understanding, reasoning, and appreciation. The findings suggest that impairment in decisional capacity is already present in cognitively impaired patients with PD without dementia and increases as these patients develop dementia. Clinicians and researchers should carefully assess decisional capacity in all patients with PD with cognitive impairment.
DOI: 10.1002/mds.22170
PubMed: 18759361
Affiliations:
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pubmed:18759361Le document en format XML
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<front><div type="abstract" xml:lang="en">Little is currently known about the higher order functional skills of patients with Parkinson disease and cognitive impairment. Medical decision-making capacity (MDC) was assessed in patients with Parkinson's disease (PD) with cognitive impairment and dementia. Participants were 16 patients with PD and cognitive impairment without dementia (PD-CIND), 16 patients with PD dementia (PDD), and 22 healthy older adults. All participants were administered the Capacity to Consent to Treatment Instrument (CCTI), a standardized capacity instrument assessing MDC under five different consent standards. Parametric and nonparametric statistical analyses were utilized to examine capacity performance on the consent standards. In addition, capacity outcomes (capable, marginally capable, or incapable outcomes) on the standards were identified for the two patient groups. Relative to controls, PD-CIND patients demonstrated significant impairment on the understanding treatment consent standard, clinically the most stringent CCTI standard. Relative to controls and PD-CIND patients, PDD patients were impaired on the three clinical standards of understanding, reasoning, and appreciation. The findings suggest that impairment in decisional capacity is already present in cognitively impaired patients with PD without dementia and increases as these patients develop dementia. Clinicians and researchers should carefully assess decisional capacity in all patients with PD with cognitive impairment.</div>
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<Abstract><AbstractText>Little is currently known about the higher order functional skills of patients with Parkinson disease and cognitive impairment. Medical decision-making capacity (MDC) was assessed in patients with Parkinson's disease (PD) with cognitive impairment and dementia. Participants were 16 patients with PD and cognitive impairment without dementia (PD-CIND), 16 patients with PD dementia (PDD), and 22 healthy older adults. All participants were administered the Capacity to Consent to Treatment Instrument (CCTI), a standardized capacity instrument assessing MDC under five different consent standards. Parametric and nonparametric statistical analyses were utilized to examine capacity performance on the consent standards. In addition, capacity outcomes (capable, marginally capable, or incapable outcomes) on the standards were identified for the two patient groups. Relative to controls, PD-CIND patients demonstrated significant impairment on the understanding treatment consent standard, clinically the most stringent CCTI standard. Relative to controls and PD-CIND patients, PDD patients were impaired on the three clinical standards of understanding, reasoning, and appreciation. The findings suggest that impairment in decisional capacity is already present in cognitively impaired patients with PD without dementia and increases as these patients develop dementia. Clinicians and researchers should carefully assess decisional capacity in all patients with PD with cognitive impairment.</AbstractText>
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<name sortKey="Okonkwo, Ozioma C" sort="Okonkwo, Ozioma C" uniqKey="Okonkwo O" first="Ozioma C" last="Okonkwo">Ozioma C. Okonkwo</name>
<name sortKey="Stover, Natividad" sort="Stover, Natividad" uniqKey="Stover N" first="Natividad" last="Stover">Natividad Stover</name>
<name sortKey="Triebel, Kristen" sort="Triebel, Kristen" uniqKey="Triebel K" first="Kristen" last="Triebel">Kristen Triebel</name>
<name sortKey="Watts, Ray L" sort="Watts, Ray L" uniqKey="Watts R" first="Ray L" last="Watts">Ray L. Watts</name>
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<country name="États-Unis"><noRegion><name sortKey="Martin, Roy C" sort="Martin, Roy C" uniqKey="Martin R" first="Roy C" last="Martin">Roy C. Martin</name>
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