Aims:The objectives of this article are to discuss ethical issues of informed consent in cognitively impaired patients and review considerations for capacity determination. We will also discuss how to evaluate capacity, determine competence, and obtain informed consent when a patient is deemed incompetent. This review emphasizes how to carry out informed consent procedures when capacity is questionable and discusses measures supported for use when determining cognitively impaired patients' ability to consent.Methods: Information was gathered from medical and psychological codes of ethics, peer-reviewed journals, published guidelines from health-care organizations (e.g., American Medical Association), and scholarly books. Google Scholar and PsycINFO were searched for articles related to 'informed consent' and 'cognitive impairment' published in English between 1975 and 2014. Relevant sources referenced in retrieved publications were subsequently searched and reviewed. Results:We selected 49 sources generated by our search. Sources were included in our review if they presented information related to at least one of our focus areas. These areas included: review of informed consent ethics and procedures, review of cognitive impairment evaluations, recommendations for measuring cognitive capacity, and alternative forms of informed consent.Conclusions: Patients' cognitive impairments can hinder the ability of patients to understand treatment options. Evaluating the capacity of patients with cognitive impairment to understand treatment options is vital for valid informed consent and should be guided by best practices. Thus, proper identification of patients with questionable capacity, capacity evaluation, and determination of competence, as well as reliance upon appropriate alternative consent procedures, are paramount.

Using diffusion tensor imaging (DTI), we assessed the relationship of white matter integrity and performance on the Boston Naming Test (BNT) in a group of retired professional football players and a control group. We examined correlations between fractional anisotropy (FA) and mean diffusivity (MD) with BNT T-scores in an unbiased voxelwise analysis processed with tract-based spatial statistics (TBSS). We also analyzed the DTI data by grouping voxels together as white matter tracts and testing each tract's association with BNT T-scores. Significant voxelwise correlations between FA and BNT performance were only seen in the retired football players ( p < 0.02). Two tracts had mean FA values that significantly correlated with BNT performance: forceps minor and forceps major. White matter integrity is important for distributed cognitive processes, and disruption correlates with diminished performance in athletes exposed to concussive and subconcussive brain injuries, but not in controls without such exposure.

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Introduction Clinical Alzheimer's disease (AD) and dementia with Lewy bodies often have mixed AD and Lewy pathology, making it difficult to delineate risk factors. Methods Six risk factors for earlier dementia onset due to autopsy‐confirmed AD (n = 647), mixed AD and Lewy body disease (AD + LBD; n = 221), and LBD (n = 63) were entered into multiple linear regressions using data from the National Alzheimer's Coordinating Center. Results In AD and AD + LBD, male sex and apolipoprotein E (APOE) ɛ4 alleles each predicted a 2‐ to 3‐year‐earlier onset and depression predicted a 3‐year‐earlier onset. In LBD, higher education predicted earlier onset and depression predicted a 5.5‐year‐earlier onset. Discussion Male sex and APOE ɛ4 alleles increase risk for earlier dementia onset in AD but not LBD. Depression increases risk for earlier dementia onset in AD, LBD, and AD + LBD, but evaluating the course, treatment, and severity is needed in future studies.

Summary: The present investigation documents memory borrowing in college-age students, defined as the telling of others' autobiographical stories as if they are one's own. In both pilot and online surveys, most undergraduates admit to borrowing personal stories from others or using details from others' experiences to embellish their own retellings. These behaviors appear primarily motivated by a desire to permanently incorporate others' experiences into one's own autobiographical record (appropriation), but other reasons include to temporarily create a more coherent or engaging conversational exchange (social connection), simplify conveying somebody else's interesting experience (convenience), or make oneself look good (status enhancement). A substantial percentage of respondents expressed uncertainty as to whether an autobiographical experience actually belonged to them or to someone else, and most respondents have confronted somebody over ownership of a particular story. Documenting memory borrowing is important as the behavior has potential consequences for the creation of false memories.