Affiliations 

  • 1 School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
  • 2 Morph Studio, Durham, North Carolina, USA
  • 3 University of Minnesota Libraries, University of Minnesota, Minneapolis, Minnesota, USA
  • 4 Hematology, APAC Disease Area Network, Roche Pharmaceuticals, Selangor, Malaysia
  • 5 Clinical Product Development, Genentech, Inc., Boston, Massachusetts, USA
  • 6 International Dementia Advocate and Connecter, Philadelphia, Pennsylvania, USA
  • 7 Stratis Health, Bloomington, Minnesota, USA
  • 8 Genia Upstream Dream, Stockholm, Sweden
  • 9 Orr Memory Clinic, Mendota Heights, Minnesota, USA
  • 10 Program for All-Inclusive Care for Elderly, St. Joseph, Michigan, USA
  • 11 Department of Neurology, Hospital Universitario, Madrid, Spain
  • 12 Product Development Medical Affairs, F. Hoffmann-La Roche Ltd., Basel, Switzerland
Gerontologist, 2024 Aug 01;64(8).
PMID: 38864593 DOI: 10.1093/geront/gnae071

Abstract

BACKGROUND AND OBJECTIVES: Older adults experiencing neurocognitive disease (NCD) contend with complex care often characterized by high emotional strain. Mitigating complex care with decision support tools can clarify options. When used in conjunction with the practice of shared decision making (SDM), these tools can improve satisfaction and confidence in treatment. The use of these tools for cognitive health has increased, but more is needed to understand how these tools incorporate social needs into treatment plans.

RESEARCH DESIGN AND METHODS: We conducted an environmental scan using a MEDLINE-informed search strategy and feedback from an expert steering committee to characterize current tools and approaches for engaging older adults experiencing NCD. We assessed their application and development, incorporation of social determinants, goals or preferences, and inclusion of caregivers in their design.

RESULTS: We identified 11 articles, 7 of which show that SDM helps guide tool development and that most center on clinical decision making. Types of tools varied by clinical site and those differences reflected patient need. A collective value across tools was their use to forge meaningful conversations. Most tools appeared designed without the explicit goal to elicit patient social needs or incorporate nonclinical strategies into treatment plans.

DISCUSSION AND IMPLICATIONS: Several challenges and opportunities exist that center on strategies to engage patients in the design and testing of tools that support conversations with clinicians about cognitive health. Future work should focus on building and testing adaptable tools that support patient and family social care needs beyond clinical care settings.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.