Evidence map›Paper›PMID 33963503›Full record

ArticleJournal of general internal medicine2022

The Association Between Mild Cognitive Impairment Diagnosis and Patient Treatment Preferences: a Survey of Older Adults.

Deborah A Levine, Andrzej T Galecki, Brenda L Plassman, Angela Fagerlin, Lauren P Wallner, Kenneth M Langa, Rachael T Whitney, Brahmajee K Nallamothu, Lewis B Morgenstern, Bailey K Reale and 5 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.4field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Influence of mild cognitive impairment on patient and care partner decision-making for acute ischemic stroke.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023
    Article
  3. Article
  4. Article
  5. Physician Diagnosis and Knowledge of Mild Cognitive Impairment.Journal of Alzheimer's disease : JAD · 2022
    Article
  6. Article
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 3 institutions in 1 country.

Deborah A LevineDepartment of Internal Medicine and Cognitive Health Services Research Program, University of Michigan (U-M), Ann Arbor, MI, USA. deblevin@umich.edu.ORCID 0000-0002-6864-8001
Andrzej T GaleckiDepartment of Internal Medicine and Cognitive Health Services Research Program, University of Michigan (U-M), Ann Arbor, MI, USA.
Brenda L PlassmanDepartment of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
Angela FagerlinDepartment of Population Health Sciences, University of Utah, and Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS 2.0) Center for Innovation, Salt Lake City, UT, USA.
Lauren P WallnerDepartment of Internal Medicine and Cognitive Health Services Research Program, University of Michigan (U-M), Ann Arbor, MI, USA.
Kenneth M LangaDepartment of Internal Medicine and Cognitive Health Services Research Program, University of Michigan (U-M), Ann Arbor, MI, USA.
Rachael T WhitneyDepartment of Internal Medicine and Cognitive Health Services Research Program, University of Michigan (U-M), Ann Arbor, MI, USA.
Brahmajee K NallamothuDepartment of Internal Medicine and Cognitive Health Services Research Program, University of Michigan (U-M), Ann Arbor, MI, USA.
Lewis B MorgensternDepartment of Neurology and Stroke Program, U-M, Ann Arbor, MI, USA.
Bailey K RealeDepartment of Internal Medicine and Cognitive Health Services Research Program, University of Michigan (U-M), Ann Arbor, MI, USA.
Emilie M BlairDepartment of Internal Medicine and Cognitive Health Services Research Program, University of Michigan (U-M), Ann Arbor, MI, USA.
Bruno GiordaniMichigan Alzheimer's Disease Center, U-M, Ann Arbor, MI, USA.
Kathleen Anne Welsh-BohmerDepartment of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
Mohammed U KabetoDepartment of Internal Medicine and Cognitive Health Services Research Program, University of Michigan (U-M), Ann Arbor, MI, USA.
Darin B ZahuranecDepartment of Internal Medicine and Cognitive Health Services Research Program, University of Michigan (U-M), Ann Arbor, MI, USA.
University of Michigan · USDuke University · USUniversity of Utah · US

Funding

Research Education CoreP30AG024824 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Neil Alexander · 2004 to 2026
$29.2M
Research Education ComponentP30AG072931 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Ana Marie Daugherty · 2021 to 2026
$26.5M
Decision Making for Cardiovascular Therapy in Adults with Mild Cognitive ImpairmentR01AG051827 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LEVINE, DEBORAH ALLISON · 2016 to 2020
$3.6M
NIA NIH HHS P30 AG024824NIA NIH HHS P30 AG072931NIA NIH HHS R01 AG051827
6 · The paper itself

Abstract

backgroundOlder patients (65+) with mild cognitive impairment (MCI) receive less guideline-concordant care for cardiovascular disease (CVD) and other conditions than patients with normal cognition (NC). One potential explanation is that patients with MCI want less treatment than patients with NC; however, the treatment preferences of patients with MCI have not been studied.

objectiveTo determine whether patients with MCI have different treatment preferences than patients with NC.

designCross-sectional survey conducted at two academic medical centers from February to December 2019

participantsDyads of older outpatients with MCI and NC and patient-designated surrogates. MAIN MEASURES: The modified Life-Support Preferences-Predictions Questionnaire score measured patients' preferences for life-sustaining treatment decisions in six health scenarios including stroke and acute myocardial infarction (range, 0-24 treatments rejected with greater scores indicating lower desire for treatment). KEY

resultsThe survey response rate was 73.4%. Of 136 recruited dyads, 127 (93.4%) completed the survey (66 MCI and 61 NC). The median number of life-sustaining treatments rejected across health scenarios did not differ significantly between patients with MCI and patients with NC (4.5 vs 6.0; P=0.55). Most patients with MCI (80%) and NC (80%) desired life-sustaining treatments in their current health (P=0.99). After adjusting for patient and surrogate factors, the difference in mean counts of rejected treatments between patients with MCI and patients with NC was not statistically significant (adjusted ratio, 1.08, 95% CI, 0.80-1.44; P=0.63).

conclusionWe did not find evidence that patients with MCI want less treatment than patients with NC. These findings suggest that other provider and system factors might contribute to patients with MCI getting less guideline-concordant care.

Indexed as

Cognition DisordersCognitive DysfunctionAgedCognitionCross-Sectional StudiesHumansSurveys and QuestionnairesagingAlzheimer’scardiovascular diseasehealth services research

Identifiers

PMID33963503
PMCPMC9198187
OpenAlexW3157159592

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.