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Competency of aMCI patients to consent to cholinesterase treatment

Published online by Cambridge University Press:  27 May 2019

Etsuko Oshima ,
Shintaro Takenoshita ,
Risa Iwai ,
Mayumi Yabe ,
Nao Imai ,
Makiko Horiuchi ,
Naoya Takeda ,
Yosuke Uchitomi ,
Norihito Yamada  and
Seishi Terada Open the ORCID record for Seishi Terada [Opens in a new window]
Etsuko Oshima
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Shintaro Takenoshita
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Risa Iwai
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Mayumi Yabe
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Nao Imai
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Makiko Horiuchi
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Naoya Takeda
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Yosuke Uchitomi
Affiliation:
Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, & Behavioral and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
Norihito Yamada
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Seishi Terada*
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
*
Correspondence should be addressed to: Seishi Terada, Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. Phone: +81-86-235-7242; Fax: +81-86-235-7246. Email: terada@okayama-u.ac.jp.
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Abstract

Background:

In medical practice, a patient’s loss of competency is a major obstacle when choosing a treatment and a starting treatment program smoothly. A large number of studies have revealed the lack of medical competency in patients with dementia. However, there have been only a few reports focusing on the capacity of patients with mild cognitive impairment (MCI) to make a medical choice.

Methods:

In this study, we evaluated the competency of 40 patients with amnestic MCI (aMCI) and 33 normal subjects to make a medical choice using the MacArthur Competence Assessment Tool-Treatment (MacCAT-T). We compared the judgement of a team conference using the recorded semi-structured interview with the clinical judgement of a chief clinician.

Results:

A team conference concluded that 12 aMCI patients had no competency, and the clinical judgement, without any special interview, judged that five aMCI patients had no competency. All subjects in the control groups were judged to be competent to consent to treatment by both clinicians and the team conference.

Conclusions:

Without supplementary tools such as explanatory documents, not a few patients with aMCI were judged by a team conference to have no competency to consent to therapy even in a relatively simple and easy case. In contrast, clinical physicians tended to evaluate the competency of aMCI patients in a generous manner.

Keywords

consentdecisiondementiaMacCAT-Tmild cognitive impairment
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 2: Issue Theme: Psychological Promoters of Well-Being in Older Adults , February 2020 , pp. 211 - 216
Copyright
© International Psychogeriatric Association 2019 

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