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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Okonkwo</name></author><author><name sortKey="Hill, Joni" sort="Hill, Joni" uniqKey="Hill J" first="Joni" last="Hill">Joni Hill</name></author><author><name sortKey="Griffith, H Randall" sort="Griffith, H Randall" uniqKey="Griffith H" first="H Randall" last="Griffith">H Randall Griffith</name></author><author><name sortKey="Triebel, Kristen" sort="Triebel, Kristen" uniqKey="Triebel K" first="Kristen" last="Triebel">Kristen Triebel</name></author><author><name sortKey="Bartolucci, Alfred" sort="Bartolucci, Alfred" uniqKey="Bartolucci A" first="Alfred" last="Bartolucci">Alfred Bartolucci</name></author><author><name sortKey="Nicholas, Anthony P" sort="Nicholas, Anthony P" uniqKey="Nicholas A" first="Anthony P" last="Nicholas">Anthony P. Nicholas</name></author><author><name sortKey="Watts, Ray L" sort="Watts, Ray L" uniqKey="Watts R" first="Ray L" last="Watts">Ray L. Watts</name></author><author><name sortKey="Stover, Natividad" sort="Stover, Natividad" uniqKey="Stover N" first="Natividad" last="Stover">Natividad Stover</name></author><author><name sortKey="Harrell, Lindy E" sort="Harrell, Lindy E" uniqKey="Harrell L" first="Lindy E" last="Harrell">Lindy E. Harrell</name></author><author><name sortKey="Clark, David" sort="Clark, David" uniqKey="Clark D" first="David" last="Clark">David Clark</name></author><author><name sortKey="Marson, Daniel C" sort="Marson, Daniel C" uniqKey="Marson D" first="Daniel C" last="Marson">Daniel C. Marson</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2008">2008</date><idno type="doi">10.1002/mds.22170</idno><idno type="RBID">pubmed:18759361</idno><idno type="pmid">18759361</idno><idno type="wicri:Area/PubMed/Corpus">002067</idno><idno type="wicri:Area/PubMed/Curation">002067</idno><idno type="wicri:Area/PubMed/Checkpoint">002223</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Medical decision-making capacity in cognitively impaired Parkinson's disease patients without dementia.</title><author><name sortKey="Martin, Roy C" sort="Martin, Roy C" uniqKey="Martin R" first="Roy C" last="Martin">Roy C. Martin</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0017, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0017</wicri:regionArea><wicri:noRegion>Alabama 35294-0017</wicri:noRegion></affiliation></author><author><name sortKey="Okonkwo, Ozioma C" sort="Okonkwo, Ozioma C" uniqKey="Okonkwo O" first="Ozioma C" last="Okonkwo">Ozioma C. Okonkwo</name></author><author><name sortKey="Hill, Joni" sort="Hill, Joni" uniqKey="Hill J" first="Joni" last="Hill">Joni Hill</name></author><author><name sortKey="Griffith, H Randall" sort="Griffith, H Randall" uniqKey="Griffith H" first="H Randall" last="Griffith">H Randall Griffith</name></author><author><name sortKey="Triebel, Kristen" sort="Triebel, Kristen" uniqKey="Triebel K" first="Kristen" last="Triebel">Kristen Triebel</name></author><author><name sortKey="Bartolucci, Alfred" sort="Bartolucci, Alfred" uniqKey="Bartolucci A" first="Alfred" last="Bartolucci">Alfred Bartolucci</name></author><author><name sortKey="Nicholas, Anthony P" sort="Nicholas, Anthony P" uniqKey="Nicholas A" first="Anthony P" last="Nicholas">Anthony P. Nicholas</name></author><author><name sortKey="Watts, Ray L" sort="Watts, Ray L" uniqKey="Watts R" first="Ray L" last="Watts">Ray L. Watts</name></author><author><name sortKey="Stover, Natividad" sort="Stover, Natividad" uniqKey="Stover N" first="Natividad" last="Stover">Natividad Stover</name></author><author><name sortKey="Harrell, Lindy E" sort="Harrell, Lindy E" uniqKey="Harrell L" first="Lindy E" last="Harrell">Lindy E. Harrell</name></author><author><name sortKey="Clark, David" sort="Clark, David" uniqKey="Clark D" first="David" last="Clark">David Clark</name></author><author><name sortKey="Marson, Daniel C" sort="Marson, Daniel C" uniqKey="Marson D" first="Daniel C" last="Marson">Daniel C. Marson</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2008" type="published">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Case-Control Studies</term><term>Cognition Disorders (complications)</term><term>Cognition Disorders (psychology)</term><term>Decision Making (physiology)</term><term>Dementia (complications)</term><term>Female</term><term>Humans</term><term>Informed Consent (psychology)</term><term>Informed Consent (standards)</term><term>Male</term><term>Mental Competency</term><term>Middle Aged</term><term>Neuropsychological Tests</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (psychology)</term><term>Physician-Patient Relations</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Cognition Disorders</term><term>Dementia</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Decision Making</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Cognition Disorders</term><term>Informed Consent</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Informed Consent</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Case-Control Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Mental Competency</term><term>Middle Aged</term><term>Neuropsychological Tests</term><term>Physician-Patient Relations</term><term>Retrospective Studies</term></keywords></textClass></profileDesc></teiHeader><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></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">18759361</PMID><DateCreated><Year>2008</Year><Month>11</Month><Day>04</Day></DateCreated><DateCompleted><Year>2009</Year><Month>04</Month><Day>08</Day></DateCompleted><DateRevised><Year>2014</Year><Month>09</Month><Day>09</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1531-8257</ISSN><JournalIssue CitedMedium="Internet"><Volume>23</Volume><Issue>13</Issue><PubDate><Year>2008</Year><Month>Oct</Month><Day>15</Day></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Medical decision-making capacity in cognitively impaired Parkinson's disease patients without dementia.</ArticleTitle><Pagination><MedlinePgn>1867-74</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/mds.22170</ELocationID><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><CopyrightInformation>(c) 2008 Movement Disorder Society.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Martin</LastName><ForeName>Roy C</ForeName><Initials>RC</Initials><AffiliationInfo><Affiliation>Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0017, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Okonkwo</LastName><ForeName>Ozioma C</ForeName><Initials>OC</Initials></Author><Author ValidYN="Y"><LastName>Hill</LastName><ForeName>Joni</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Griffith</LastName><ForeName>H Randall</ForeName><Initials>HR</Initials></Author><Author ValidYN="Y"><LastName>Triebel</LastName><ForeName>Kristen</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Bartolucci</LastName><ForeName>Alfred</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Nicholas</LastName><ForeName>Anthony P</ForeName><Initials>AP</Initials></Author><Author ValidYN="Y"><LastName>Watts</LastName><ForeName>Ray L</ForeName><Initials>RL</Initials></Author><Author ValidYN="Y"><LastName>Stover</LastName><ForeName>Natividad</ForeName><Initials>N</Initials></Author><Author ValidYN="Y"><LastName>Harrell</LastName><ForeName>Lindy E</ForeName><Initials>LE</Initials></Author><Author ValidYN="Y"><LastName>Clark</LastName><ForeName>David</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Marson</LastName><ForeName>Daniel C</ForeName><Initials>DC</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>1P50 AG16582</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>1R01 AG021927</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 AG021927</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 AG021927-05</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Arch Neurol. 1995 Oct;52(10):949-54</RefSource><PMID 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Version="1">15133814</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Intern Med. 2004 Sep;256(3):240-6</RefSource><PMID Version="1">15324367</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Psychiatr Res. 1975 Nov;12(3):189-98</RefSource><PMID Version="1">1202204</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Psychiatr Res. 1982-1983;17(1):37-49</RefSource><PMID Version="1">7183759</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Neurology. 1996 Mar;46(3):666-72</RefSource><PMID Version="1">8618664</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D016022">Case-Control Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D003072">Cognition Disorders</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000150">complications</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000523">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D003657">Decision Making</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000502">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D003704">Dementia</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000150">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005260">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D007258">Informed Consent</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000523">psychology</QualifierName><QualifierName MajorTopicYN="N" UI="Q000592">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008297">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D016743">Mental Competency</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008875">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D009483">Neuropsychological Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010300">Parkinson Disease</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000150">complications</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000523">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010817">Physician-Patient Relations</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012189">Retrospective Studies</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">NIHMS65724</OtherID><OtherID 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David" sort="Clark, David" uniqKey="Clark D" first="David" last="Clark">David Clark</name><name sortKey="Griffith, H Randall" sort="Griffith, H Randall" uniqKey="Griffith H" first="H Randall" last="Griffith">H Randall Griffith</name><name sortKey="Harrell, Lindy E" sort="Harrell, Lindy E" uniqKey="Harrell L" first="Lindy E" last="Harrell">Lindy E. Harrell</name><name sortKey="Hill, Joni" sort="Hill, Joni" uniqKey="Hill J" first="Joni" last="Hill">Joni Hill</name><name sortKey="Marson, Daniel C" sort="Marson, Daniel C" uniqKey="Marson D" first="Daniel C" last="Marson">Daniel C. Marson</name><name sortKey="Nicholas, Anthony P" sort="Nicholas, Anthony P" uniqKey="Nicholas A" first="Anthony P" last="Nicholas">Anthony P. Nicholas</name><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></noCountry><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></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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