Executive dysfunction and loss of capacity to consent to medical treatment in patients with Alzheimer's disease.
Executive dysfunction and loss of capacity to consent to medical treatment in patients with Alzheimer's disease.
复制标题
阿尔茨海默病患者的执行功能障碍和同意接受治疗的能力丧失。
DOI：
10.1053/scnp00400041
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Harrell,L
中科院分区：
文献类型：
--
作者：
Marson,D;Harrell,L
医疗决策能力（能力）的丧失是阿尔茨海默病（AD）不可避免的后果，也是神经心理学研究的一个重要课题。同意能力涉及一套复杂的理解、编码、信息处理、决策和沟通能力，最终必须有明确的神经学基础。这篇文章探讨了执行功能障碍在AD患者同意能力丧失中的作用。作者首先描述了一个认知神经心理学模型来理解AD患者同意能力的丧失。本文还回顾了神经心理学研究，这些研究使用心理测量工具来测试不同法律标准下的同意能力（同意治疗工具的能力）。这些研究表明，当多种认知功能与AD患者在同意治疗工具法律标准上的能力下降有关时，简单执行功能的测量是主要的预测因子。这些实证研究结果进行了讨论，并与概念模型相关。这些发现支持了越来越多的将额叶神经系统和执行认知功能与能力和高级功能能力联系起来的文献。
Loss of medical decision making capacity (competency) is an inevitable consequence of Alzheimer's disease (AD) and is an important subject for neuropsychological investigation. Consent capacity involves a complex set of comprehension, encoding, information processing, decision making, and communication abilities, which ultimately must have an explicit neurological basis. This article examines the role of executive dysfunction in loss of consent capacity in patients with AD. The authors first describe a cognitive neuropsychological model for understanding loss of consent capacity in AD. The article also reviews neuropsychological studies that have used a psychometric instrument to test consent capacity under different legal standards (Capacity to Consent to Treatment Instrument). These studies indicate that when multiple cognitive functions are associated with declining competency of AD patients on the Capacity to Consent to Treatment Instrument legal standards, measures of simple executive function are the predominant predictors. These empirical findings are discussed and related to the conceptual model. The findings support the growing body of literature linking frontal neural systems and executive cognitive functions to competency and to higher order functional capacities.