2024 Alzheimer's Association Research Grant to Promote Diversity (AARG-D)
Advance care planning and end of life in cognitively impaired older adults
How can we ensure people living with Alzheimer’s have quality end-of-life care?
Zahra Rahemi, Ph.D.
Clemson University
Clemson, SC - United States
Background
Alzheimer’s is a progressive brain disease that impacts memory, thinking, and behavior. Many older adults with Alzheimer’s or mild cognitive impairment (MCI, a state of subtle memory loss that may precede Alzheimer’s) progressively lose some cognitive capacities while retaining others. This can make it challenging to make big life decisions, specifically those related to financial planning, medical decision-making, and advanced care/end-of-life planning. Additionally, studies have shown that increasing costs for end-of-life care have made it difficult for older adults with Alzheimer’s to adhere to the advanced care plans that were made before their diagnosis.
Research Plan
For their project, Dr. Zahra Rahemi and the team will study how advance care planning “adherence” changes as Alzheimer’s progresses and what factors contribute to one’s adherence. They will do this by leveraging data from participants in the Health and Retirement Study, aged 65 years and older, who also have matched Medicare data. Next, the team will assess how the quality of end-of-life care and overall healthcare costs differ between individuals who were adherent to their advanced care plan versus those who were not adherent. Lastly, the researchers will examine if social determinants of health, including race/ethnicity, education, and income, impact the quality of end-of-life care and adherence.
Impact
The results of this project may help us better understand the factors that prevent older adults with Alzheimer’s from adhering to their end-of-life plans. If successful, the findings could lead to new programs to improve advanced care planning adherence in this population.