Shared decision making in mild cognitive impairment

Mejia, Andrea; Smith, Glenn E.; Wicklund, Meredith; Armstrong, Melissa J.

doi:10.1212/cpj.0000000000000576

Cited by 16 publications

(16 citation statements)

References 24 publications

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“…In line with previous research [32], we advocate that professionals must be aware of changing roles of families in shared decision making and discuss these roles over time. In that, professionals must consider (cognitive) capabilities of families, the age of children, and always discuss families values and preferences [56]. Unfortunately, to date there are few guidelines applied by professionals to discuss multiple perspectives and preferences in integrated care [5].…”

Section: Discussionmentioning

confidence: 99%

What Do Parents Expect in the 21st Century? A Qualitative Analysis of Integrated Youth Care

et al. 2020

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Introduction: To provide integrated Youth Care responsive to the needs of families with multiple problems across life domains, it is essential to incorporate parental perspectives into clinical practice. The aim of this study is to advance our understanding of key components of integrated Youth Care from a parental perspective. Methods: Semi-structured interviews were administered to 21 parents of children receiving Youth Care from integrated care teams in the Netherlands. Qualitative content analysis was conducted by means of a grounded theory approach following qualitative reporting guidelines. Results and discussion: Parental perspectives were clustered into six key components: a holistic, family-centred approach; addressing a broad range of needs in a timely manner; shared decision making; interprofessional collaboration; referral; and privacy. Parents emphasized the importance of a tailored, family-centred approach, addressing needs across several life domains, and active participation in their own care process. However, they simultaneously had somewhat opposing expectations regarding these key components, for example, concerning the changing roles of professionals and parents in shared decision making and the value of involving family members in a care process. Professionals should be aware of these opposing expectations by explicitly discussing mutual expectations and changing roles in decision making during a care process. To enable parents to make their own decisions, professionals should transparently propose different options for support guided by an up-to-date care plan.

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Section: Discussionmentioning

confidence: 99%

What Do Parents Expect in the 21st Century? A Qualitative Analysis of Integrated Youth Care

et al. 2020

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“…Since then, clinical, imaging, genetic, pathological, and epidemiological studies have been carried out [2]. MCI is considered to be a transitional stage between normal aging and Alzheimer’s disease (AD), and is characterized by cognition impairment that does not interfere with the usual activities of daily living [3,4]. Impairment in memory, attention, and other cognitive domains is more severe in MCI than one would expect for a given age and educational level [5].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Cocoa Polyphenols in the Treatment of Mild Cognitive Impairment: A Retrospective Study

et al. 2019

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Background: Mild cognitive impairment (MCI) is characterized by cognition impairment that does not interfere with the usual activities of daily living. It is considered to be a transitional stage between normal aging and dementia. No treatment is available for MCI. Methods: This retrospective cohort study included 55 patients (29 males and 26 females, aged 56–75 years) with a diagnosis of amnestic MCI who attended the Center for Cognitive Disorder and Dementia of the IRCCS Centro Neurolesi Bonino Pulejo (Messina, Italy) between January and December of 2017. As we aimed to evaluate the effect of cocoa polyphenols on cognition, the study population was separated into two groups depending on the change in their Mini-Mental State Examination (MMSE) score at a one-year follow-up. Results: Compared to G2 (i.e., patients with a worsening in cognitive functions), the rate of polyphenol intake was significantly higher in patients without a worsening in cognition (i.e., G1) (χ2 = 13.79, df = 1, p-value < 0.001). By subdividing G1 patients based on whether they improved or were stable at follow-up, we found that 46.2% of those who had improved were treated with polyphenols. Conclusions: Dietary supplementation of cocoa flavonoids seems to reduce the progression of MCI to dementia. Further prospective studies with larger sample volumes are required to confirm these promising findings.

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“…Shared decision-making-a partnership between patients and clinicians where patients' values and preferences as well as the best medical evidence are considered [25]-is a critical component of high quality care, and only possible when the patients understand their diagnosis and prognosis. Particularly for patients with MCI, care partners play an important role in making decisions as they can learn patients' values and preferences and use this knowledge to be the patients' proxy when the patients' cognitive function declines [13,26]. However, while patients with MCI may have the greatest opportunity to benefit from shared decision making, it should be acknowledged that promoting shared decision making in these circumstances may be the most challenging given the high ambiguity associated with the result of the amyloid PET scan and prognosis in this population.…”

Section: Clinical Practice Implicationsmentioning

confidence: 99%

“…Given these uncertainties, it is important that patients and their care partners understand the limited definitiveness of positive results particularly for MCI patients. Further, care partners of MCI patients have an opportunity to learn patient's values and preferences to inform future decision making if patients' experience further cognitive decline [13], which emphasizes the importance of care partners' understanding of scan results.…”

Section: Introductionmentioning

confidence: 99%

How Accurately Do Patients and Their Care Partners Report Results of Amyloid-β PET Scans for Alzheimer’s Disease Assessment?

James

Houtven

Lippmann

et al. 2020

JAD

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Background: Amyloid-β PET scans will likely become an integral part of the diagnostic evaluation for Alzheimer's disease if Medicare approves reimbursement for the scans. However, little is known about patients' and their care partners' interpretation of scan results. Objective: This study seeks to understand how accurately patients with mild cognitive impairment (MCI) or dementia and their care partners report results of amyloid-β PET scans and factors related to correct reporting. Methods: A mixed-methods approach was used to analyze survey data from 1,845 patient-care partner dyads and responses to open-ended questions about interpretation of scan results from a sub-sample of 200 dyads. Results: Eighty-three percent of patients and 85% of care partners correctly reported amyloid-β PET scan results. Patients' higher cognitive function was associated with a small but significant decrease in the predicted probability of not only patients accurately reporting scan results

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Shared decision making in mild cognitive impairment

Cited by 16 publications

References 24 publications

What Do Parents Expect in the 21st Century? A Qualitative Analysis of Integrated Youth Care

What Do Parents Expect in the 21st Century? A Qualitative Analysis of Integrated Youth Care

The Efficacy of Cocoa Polyphenols in the Treatment of Mild Cognitive Impairment: A Retrospective Study

How Accurately Do Patients and Their Care Partners Report Results of Amyloid-β PET Scans for Alzheimer’s Disease Assessment?

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