Predictors of Decisional Capacity in Alzheimer's Disease Biomarker Test Candidates.
Jeong Eun Kim, Susan M Sereika, Lisa K Tamres and 1 others
PMID 39616431WHAT IT FOUND
All 164 people with mild cognitive impairment and their care partners had sufficient capacity to consent to AD biomarker research.
Higher cognition, better disease knowledge, and faster processing speed were linked to greater capacity.
Key findings
01All 164 participants, including 82 persons with MCI and 82 care partners, had sufficient capacity to consent.
02For persons with MCI, higher MMSE scores and greater MCI/AD knowledge were positively associated with decisional capacity, while slower TMT-A completion was associated with lower capacity.
03In dyadic analysis, a person's own MCI/AD knowledge predicted their own capacity, but a care partner's greater knowledge predicted lower capacity in the person with MCI.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was mostly White and highly educated, so results may not apply to more diverse populations. The study used baseline data from a research consent setting after a pre-counseling session, so it does not show how capacity behaves in ordinary clinical care. It was cross-sectional and correlational, so it cannot show that age, cognition, knowledge, or processing speed cause changes in decisional capacity. The UBACC is designed to identify capacity deficits, not to distinguish levels of intact capacity, and all scores were at or above the cutoff. No clinician perspectives were included, so the paper cannot say how clinicians would use these findings.
Declared interests
The supplied publication types list Research Support, N.I.H., Extramural. No conflicts of interest or funding declaration appears in the supplied text.
The easy way to misread this
Do not conclude that people with MCI generally lack capacity to consent. All 164 participants scored at or above the UBACC cutoff, and the study did not test whether education improves capacity.