Frequency and correlates of advance planning among cognitively impaired older adults

Am J Geriatr Psychiatry. 2008 Aug;16(8):643-9. doi: 10.1097/JGP.0b013e31816b7324.


Objective: To examine the prevalence and sociodemographic correlates of written advance planning among patients with or at risk for dementia-imposed decisional incapacity.

Design: Retrospective, cross-sectional.

Setting: University-based memory disorders clinic.

Participants: Persons with a consensus-based diagnosis of mild cognitive impairment (N = 112), probable or possible Alzheimer disease (AD; N = 549), and nondemented comparison subjects (N = 84).

Intervention: N/A.

Measurements: Semistructured interviews to assess durable power of attorney (DPOA) and living will (LW) status upon initial presentation for a dementia evaluation.

Results: Sixty-five percent of participants had a DPOA and 56% had a LW. Planning rates did not vary by diagnosis. European Americans (adjusted odds ratio = 4.75; 95% CI, 2.40-9.38), older adults (adjusted odds ratio = 1.05; 95% CI, 1.03-1.07) and college graduates (adjusted odds ratio = 2.06; 95% CI, 1.33-3.20) were most likely to have a DPOA. Findings were similar for LW rates.

Conclusions: Although a majority of persons with and at risk for the sustained and progressive decisional incapacity of AD are formally planning for the future, a substantial minority are not.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Advance Directives* / ethnology
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease*
  • Cognition Disorders*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Memory Disorders*
  • Middle Aged
  • Pennsylvania
  • Retrospective Studies
  • Socioeconomic Factors