Background: There is a lack of research on differences between decision-making capacity and awareness according to age at onset of dementia. We investigated the relationship between decision-making capacity and awareness domains in people with young- (YOAD) and late-onset Alzheimer´s Disease (LOAD).
Method: A cross-sectional study included 169 consecutively selected people with AD and their caregivers (124 people with LOAD and 45 people with YOAD).
Result: People with YOAD were more cognitively impaired, but more aware of their cognitive deficits and health condition, with moderate effect sizes. All people with AD presented deficits in the domains of decision-making capacity, with more impairment in understanding. There was a relationship between understanding and awareness domains, such that awareness was particularly important for decision-making capacity in the YOAD group.
Conclusion: Better awareness involved better understanding in the YOAD group. Clinically, our findings shed light on the need to consider the differences in the domains of awareness and their relationship with other clinical aspects such as decision-making capacity according to age at onset of AD.
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http://dx.doi.org/10.1002/alz.089444 | DOI Listing |
Gen Hosp Psychiatry
December 2024
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Division of Patient Safety, Keio University School of Medicine, Tokyo, Japan. Electronic address:
Objectives: Treatment decisions for severe aortic stenosis (AS) are complex, since there are two active and comparable options: transcatheter aortic valve implantation and surgical aortic valve replacement. The disease predominantly affects older individuals, who are frequently comorbid with from cognitive impairment. This study aimed to establish a screening-triggered system to assess the decision-making capacity of patients with AS, support their decision-making, and facilitate referrals to specialists when necessary.
View Article and Find Full Text PDFJ Environ Manage
January 2025
College of Water Sciences, Beijing Normal University, Beijing, 100875, China.
Identifying landscape patterns conducive to pollutant transport control is of vitally importance for water quality protection. However, it remains unclear which landscape patterns can weaken the transport capacity of pollutants entering water bodies. To fill this gap, this study proposes a new framework.
View Article and Find Full Text PDFBMC Public Health
January 2025
Chronic Disease and Injury Prevention, Public Health Ontario, 480 University Avenue, Toronto, Ontario, M5G 1V2, Canada.
Background: Road-related injuries and deaths are among the most significant and avoidable public health problems in Canada. Modifications to the built environment (BE) can reduce injury rates for vulnerable road users (VRUs) and other priority populations who experience disproportionate risk. This paper highlights public health professionals' experiences working in injury prevention across Ontario public health units (PHUs) navigating barriers and facilitators to BE change.
View Article and Find Full Text PDFPsychon Bull Rev
January 2025
School of Psychology, UNSW Sydney, Sydney, Australia.
The naiveté of the dominant 'cognitive-miser' metaphor of human thinking hampers theoretical progress in understanding how and why subtle behavioural interventions-'nudges'-could work. We propose a reconceptualization that places the balance in agency between, and the alignment of representations held by, people and choice architects as central to determining the prospect of observing behaviour change. We argue that two aspects of representational (mis)alignment are relevant: cognitive (how people construe the factual structure of a decision environment) and motivational (the importance of a choice to an individual).
View Article and Find Full Text PDFBMJ Open
January 2025
Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Objectives: This study aimed to explore the ethical challenges faced by healthcare professionals (HCPs) in managing children and adolescents with neurodevelopmental disorders (NDDs) in Lebanon. The primary research question addressed how HCPs navigate ethical dilemmas related to patient autonomy, surrogate decision-making and communication in the context of severe cognitive impairments.
Design: Qualitative, cross-sectional study using semi-structured interviews.
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