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• W19791489 abstract "Back to table of contents Previous article Next article Full AccessDurable power of attorney and informed consent with Alzheimer's disease patients: a clinical studyPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.154.8.1070AboutSectionsView articleAbstractPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleAbstractOBJECTIVE: Experience with a new surrogate consent system for patients with Alzheimer's disease is reviewed. It was hypothesized that as patients' cognitive status deteriorated, surrogate consent through a durable power of attorney would become necessary to facilitate continued involvement in clinical research. METHOD: The authors retrospectively reviewed the charts of inpatients with Alzheimer's disease who participated in research between January 1989 and December 1994 at the Geriatric Psychiatry Unit of the National Institute of Mental Health. Seventy-nine patients were included. The main outcome measures were the Clinical Dementia Rating, Global Deterioration Scale for primary degenerative dementia, and Mini-Mental State. RESULTS: Most patients were in the mild-to-moderate stage of the illness when they chose to participate in research and assign a durable power of attorney (96% scored 2 or less on the Clinical Dementia Rating, and 92% scored 5 or less on the Global Deterioration Scale). On average, the subjects participated in 3.8 (SD = 2.6) studies. For 35 patients with multiple admissions over this period (average = 3.1 years), scores on the Clinical Dementia Rating and Global Deterioration Scale declined by 1.0 and 1.5 points, respectively. CONCLUSIONS: The durable power of attorney allows research participation for subjects with Alzheimer's disease at all stages. The linchpin is assignment of a durable power of attorney in the early-to-moderate stage of Alzheimer's disease, before subjects lose the capacity to give informed consent. This approach could also be adapted to patients with cognitive decline due to other debilitating diseases. FiguresReferencesCited byDetailsCited byEthics Guideline Development for Neuroscience Research involving Patients with Mental Illness in Japan10 February 2023 | Asian Bioethics Review, Vol. 5Resources, methods, and data infrastructure to promote research in dementia care, caregiving, and services10 July 2021 | Journal of the American Geriatrics Society, Vol. 69, No. 7Aging & Mental Health, Vol. 23, No. 7The Gerontologist, Vol. 58, No. 4, Vol. 89Behavioral Sciences & the Law, Vol. 24, No. 4Dementia and Geriatric Cognitive Disorders, Vol. 22, No. 1Do Elderly Persons’ Concerns for Family Burden Influence their Preferences for Future Participation in Dementia Research?The Journal of Clinical Ethics, Vol. 16, No. 2, Vol. 8The American Journal of Geriatric Psychiatry, Vol. 13, No. 4Can adults with cognitive impairment consent to take part in research?Journal of Wound Care, Vol. 13, No. 7Proxy and Surrogate Consent in Geriatric Neuropsychiatric Research: Update and RecommendationsScott Y.H. Kim, M.D., Ph.D., Paul S. Appelbaum, M.D., Dilip V. Jeste, M.D., and Jason T. Olin, Ph.D. 1 May 2004 | American Journal of Psychiatry, Vol. 161, No. 5Assessing Differences in Care Needs and Service Utilization in Geriatric Palliative Care PatientsJournal of Pain and Symptom Management, Vol. 23, No. 5Psychiatric Clinics of North America, Vol. 25, No. 3Journal of the American Medical Directors Association, Vol. 3, No. 2Medical Care, Vol. 40, No. SupplementA Survey of Use of a Durable Power of Attorney to Admit Geropsychiatric PatientsDavid J. Rissmiller, D.O., Erica Musser, D.O., Walter Rhoades, D.O., Frances R. Rissmiller, Ph.D., and Robert A. Steer, Ed.D.1 January 2001 | Psychiatric Services, Vol. 52, No. 1Journal of the American Geriatrics Society, Vol. 49, No. 8Alzheimer Disease and Associated Disorders, Vol. 14, No. 1Citalopram and Sexual Side Effects of Selective Serotonin Reuptake InhibitorsSTEFANO PALLANTI, M.D., , and LORRIN M. KORAN, M.D., 1 May 1999 | American Journal of Psychiatry, Vol. 156, No. 5Admission of Alzheimer’s Disease Patients to Locked Special Care Facilities Against Their WillDAVID W. CRUMPACKER, M.D., and CATHERINE S. FONTAINE, M.D., 1 May 1999 | American Journal of Psychiatry, Vol. 156, No. 5Capacity to consent in dementia and the additional costs of implementing the Bournewood Judgement in geriatric psychiatry9 June 2010 | Aging & Mental Health, Vol. 3, No. 2International Journal of Geriatric Psychiatry, Vol. 14, No. 10Biological Psychiatry, Vol. 46, No. 8Accountability in Research, Vol. 7, No. 2-4Genetic Testing, Vol. 3, No. 1Journal of Palliative Medicine, Vol. 2, No. 3International Journal of Geriatric Psychiatry, Vol. 13, No. 11The American Journal of Geriatric Psychiatry, Vol. 6, No. 2New Directions for Mental Health Services, Vol. 24, No. 76 Volume 154Issue 8 August 1997Pages 1070-1075 Metrics PDF download History Published online 1 April 2006 Published in print 1 August 1997" @default.
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• W19791489 title "Durable power of attorney and informed consent with Alzheimer's disease patients: a clinical study" @default.
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