Age and life-sustaining treatment preferences in Parkinson disease Neurology Clinical Practice Jackowiak E, Szpara A, Kotagal V. Age and life-sustaining treatment preferences in Parkinson disease. Neurology Clinical Practice 2020; 10.1212/CPJ.0000000000000948; doi: 10.1212/CPJ.0000000000000948
Date
09/15/2020Abstract
Objective/Methods: We conducted a cross-sectional survey of 39 participants (mean age 70.3 years; range: 52-81) with PD to explore correlations between older age and life-sustaining treatment preferences while controlling for confounders including years of education and Montreal Cognitive Assessment (MoCA) score, and Movement Disorders Society Unified Parkinson’s disease Rating Scale (MDS-UPDRS) motor score. Scenarios asked participants to choose their level of interest in pursuing life-sustaining measures in the setting of specific medical illnesses including stroke, metastatic cancer, severe heart attack, and dementia. All participants were men and were recruited from the Ann Arbor Veterans Affairs Health System.
Results: In the hypothetical stroke, metastatic colon cancer, and dementia scenarios, older age correlated with more aggressive care goals related to the use cardiopulmonary resuscitation to treat cardiopulmonary arrest.
Conclusions: Advancing age in PD may correlate with paradoxically more aggressive goals as it relates to life sustaining treatment preferences including cardiopulmonary resuscitation. This may reflect a response to heightened concern among older adults with PD about the potential for compromised autonomy in the setting of aging.
Author List
Jackowiak E, Szpara A, Kotagal VAuthor
Eric Jackowiak MD Assistant Professor in the Neurology department at Medical College of WisconsinView Online
