Observational studyJournal of pain and symptom management2021
Does it Matter Who Decides? Outcomes of Surrogate Decision-Making for Community-Dwelling, Cognitively Impaired Older Adults Near the End of Life.
Observational study in Journal of pain and symptom management, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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.
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.
Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- Surrogate Decision-Making for Older Adults With and Without Dementia.JAMA network open · 2026Article
- The economics of decision-making in dementia care and related life-limiting illness: a narrative review.Health economics review · 2026Review
- End-of-life dementia: demographic, clinical as well as direct health care cost differences in nursing homes vs. ordinary housing.BMC health services research · 2026Article
- Consent in Intensive Care: The Concurrence of Patients' and Families' Viewpoints. A Simulation StudyDeutsches Arzteblatt international · 2026Article
- Advance care planning in adults ages 80 years and older with impaired cognition: Using actual conversations to examine best practices.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- How do surrogates make treatment decisions for patients with dementia: An experimental survey study.Health economics · 2024Article
- Decision Making for Patients With Severe Dementia Versus Normal Cognition Near the End of Life.Innovation in aging · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
contextCognitively impaired older adults frequently need surrogate decision-making near the end-of-life. It is unknown whether differences in the surrogate's relationship to the decedent are associated with different end-of-life treatment choices.
objectivesTo describe differences in end-of-life care for community dwelling, cognitively impaired older adults when children and spouses are involved in decision-making.
methodsRetrospective observational study.
resultsAmong 742 community-dwelling adults with cognitive impairment (mild cognitive impairment or dementia) prior to death, children participated in end-of-life decisions for 615 patients (83%) and spouses participated in decisions for 258 patients (35%), with both children and spouses participating for 131 patients (18%). When controlling for demographic characteristics, decedents with only a spouse decision-maker were less likely to undergo a life-sustaining treatment than decedents with only children decision-makers (P < 0.05). There was no difference in the probability of in-hospital death or burdensome transfers across facilities across decedent-decision-maker relationships. Differences in rates of life-sustaining treatment were greater when we restricted to decedents with dementia.
conclusionDecedents with cognitive impairment or dementia were less likely to receive life-sustaining treatments when spouses versus children were involved with end-of-life treatment decisions but were no less likely to experience other measures of potentially burdensome end-of-life care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.