Decisions about Cancer Screening in Alzheimer's Disease
关于阿尔茨海默病癌症筛查的决定
基本信息
- 批准号:9924427
- 负责人:
- 金额:$ 46.87万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-09-30 至 2022-04-30
- 项目状态:已结题
- 来源:
- 关键词:AgeAlzheimer&aposs DiseaseAlzheimer&aposs disease related dementiaBenefits and RisksBreast Cancer DetectionCaregiver supportCaregiversCaringClinicalConflict (Psychology)Control GroupsDataDecision AidDecision MakingDementiaDementia caregiversDiseaseEmotionsFamily CaregiverFrequenciesGoalsGuidelinesImpaired cognitionIncidenceIndianaInterventionKnowledgeLearningLife ExpectancyLife ExperienceMalignant NeoplasmsMammographic screeningMammographyMedialMedicalPatientsPharmaceutical PreparationsPopulationPrimary Care PhysicianPrimary Health CareProceduresQuality of lifeRandomizedRandomized Controlled TrialsRiskScreening for cancerSelf EfficacyTestingWomancaregiver interventionscomorbiditydesignevidence baseexperiencefollow-upimprovedinnovationmalignant breast neoplasmnovelolder womenovertreatmentprimary outcomepsychologicrandomized trialrecruitscreeningsecondary outcome
项目摘要
Project Summary/Abstract:
The incidence of both Alzheimer’s disease and related dementias (AD) and of breast cancer increases with
age; thus, many older women with AD are faced with questions about breast cancer screening. Having AD
impacts a woman’s life expectancy and their ability to participate in her medical decision-making about breast
cancer screening. As a result, AD family caregivers are frequently involved in making decisions about
mammography. Each year over 800,000 older women with AD receive screening mammography. Caregivers
cite decision-making and procedures related to mammograms as particularly stressful and there is no data that
mammography screening helps women with AD live longer or better.
No randomized trials evaluating the benefits and harms of mammography screening include women with AD
and current guidelines recommend not screening women with a life expectancy of <10 years. The rationale is
that these women will not live long enough to experience the life prolonging benefits of mammography
screening. Instead, screening these women can put them at risk for physical and psychological harm as a
result of overdiagnosis, overtreatment, additional tests due to false positives, and the identification of clinically
unimportant cancer. Conversely, while mammography screening may not help older women with AD live
longer, it may help find breast cancers earlier when they are easier to treat. Therefore, it is important that
women with AD and their caregivers have information to make an informed decision about screening.
Decision aids have promise to improve the quality of medical decision-making for patients with AD and inform
family caregivers about the risks, benefits, and choices about screening mammography in this population. Our
team has created and evaluated a mammogram decision aid for use with caregivers of older women with AD.
This decision aid includes specific information about the relationship between life expectancy with AD and
benefit from mammograms, the impact of mammography on quality of life for older women with AD, and a
recognition of the emotions and experience of caregivers when making decisions about mammography for a
relative with AD.
We are proposing the Decisions about Cancer screening in Alzheimer's Disease (DECAD) study, as the first
study to test if an evidence-based decision aid for AD caregivers can support decision-making about
mammography and improve the quality of medical decision-making about breast cancer screening. This large
randomized controlled trial will recruit 426 dyads of older women with AD and a family caregiver from 24
primary care practices in central Indiana to test this decision aid.
项目摘要/摘要:
阿尔茨海默病和相关痴呆症(AD)以及乳腺癌的发病率都随着
年龄;因此,许多患有AD的老年妇女面临着乳腺癌筛查的问题。患有老年痴呆症
影响女性的预期寿命和她们参与乳房医疗决策的能力
癌症筛查。因此,AD的家庭照顾者经常参与做出关于
乳房X光检查。每年有超过80万患有AD的老年妇女接受筛查乳房X光检查。护理者
提到与乳房X光检查相关的决策和程序特别有压力,而且没有数据表明
乳房X光检查可以帮助患有AD的女性活得更长或更好。
没有评估乳房X光检查的益处和危害的随机试验包括AD患者
目前的指导方针建议不要对预期寿命为10年的女性进行筛查。其基本原理是
这些妇女不会活到足够长的时间来体验乳房X光检查延长生命的好处
放映。相反,对这些女性进行筛查可能会使她们面临身体和心理伤害的风险
过度诊断、过度治疗、由于假阳性而进行的额外检查以及临床诊断结果
不重要的癌症。相反,虽然乳房X光检查可能不会帮助患有AD的老年女性存活
更长的时间,当乳腺癌更容易治疗时,它可能有助于更早地发现乳腺癌。因此,重要的是
患有阿尔茨海默病的妇女和她们的照顾者有信息来做出关于筛查的知情决定。
决策辅助工具有望提高AD患者的医疗决策质量并提供信息
家庭照顾者了解在这一人群中筛查乳房X光检查的风险、好处和选择。我们的
该团队已经创建并评估了一种乳房X光检查决策辅助工具,供患有AD的老年妇女的照顾者使用。
该决策辅助工具包括有关AD患者的预期寿命与
受益于乳房X光检查,乳房X光检查对患有AD的老年女性生活质量的影响,以及
在做出关于乳房X光检查的决定时,对照顾者的情绪和经验的认识
与AD相关。
我们提出了关于阿尔茨海默病癌症筛查的决定(DECAD)研究,作为第一个
一项旨在测试针对AD照顾者的循证决策辅助工具是否可以支持决策的研究
提高乳腺癌筛查的医疗决策质量。这么大
随机对照试验将招募426对患有阿尔茨海默病的老年女性和24名家庭照顾者
印第安纳州中部的初级保健实践,以测试这一决策援助。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Nicole R. Fowler其他文献
Revised 12/30/2017 BELUGA WHALE (Delphinapterus leucas): Eastern Chukchi Sea Stock STOCK DEFINITION AND GEOGRAPHIC RANGE Beluga whales are distributed throughout seasonally ice-covered arctic and subarctic waters of the Northern Hemisphere
修订日期 12/30/2017 白鲸 (Delphinapterus leucas):东楚科奇海种群 种群定义和地理范围 白鲸分布在北半球季节性冰雪覆盖的北极和亚北极水域
- DOI:
- 发表时间:
2018 - 期刊:
- 影响因子:0
- 作者:
J. Flatt;A. Rosso;H. Aizenstein;R. Schulz;W. Longstreth;A. Newman;Nicole R. Fowler;C. Rosano - 通讯作者:
C. Rosano
Accurate Assessments of Healthcare Use Along the Course of Cognitive Decline
认知衰退过程中医疗保健使用的准确评估
- DOI:
- 发表时间:
2013 - 期刊:
- 影响因子:6.3
- 作者:
Nicole R. Fowler - 通讯作者:
Nicole R. Fowler
Engaging Persons Living With Dementia in the Research Process: Best Practice Considerations From a National Dementia Meeting.
让痴呆症患者参与研究过程:全国痴呆症会议的最佳实践考虑因素。
- DOI:
10.1016/j.jagp.2019.11.008 - 发表时间:
2019 - 期刊:
- 影响因子:0
- 作者:
Kathleen Rukes;Nicole R. Fowler - 通讯作者:
Nicole R. Fowler
Agile monitoring dashboard for clinical research studies
- DOI:
10.1186/s13063-024-08646-0 - 发表时间:
2024-11-29 - 期刊:
- 影响因子:2.000
- 作者:
Leslie Gardner;Peggy Bylund;Sarah Robbins;Emma Holler;Fereshtehossadat Shojaei;Fatemehalsadat Shojaei;Mark Seidman;Richard J. Holden;Nicole R. Fowler;Ben Zarzaur;Cristina Barboi;Malaz Boustani - 通讯作者:
Malaz Boustani
Performance of Older Adults on the Digital Clock and Recall Test Compared to the Montreal Cognitive Assessment in Primary Care Settings
- DOI:
10.1007/s11606-025-09702-4 - 发表时间:
2025-07-09 - 期刊:
- 影响因子:4.200
- 作者:
Dustin B. Hammers;Daniel Schulman;Nicole R. Fowler;Jane Musema;Jared R. Brosch;Diana Summanwar;Kristen Swartzell;Connor Higgins;Russell Banks;Katherine J. Selzler;Timothy MacLeod;Sean Tobyne;Deanna R. Willis - 通讯作者:
Deanna R. Willis
Nicole R. Fowler的其他文献
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{{ truncateString('Nicole R. Fowler', 18)}}的其他基金
Alzheimer Diagnosis in older Adults with Chronic Conditions ADACC Network
患有慢性病的老年人的阿尔茨海默病诊断 ADACC 网络
- 批准号:
10726511 - 财政年份:2023
- 资助金额:
$ 46.87万 - 项目类别:
RememberStuff: a dyadic-focused technology to support persons with Alzheimer's disease in the community
RememberStuff:一种以二元为重点的技术,为社区中的阿尔茨海默病患者提供支持
- 批准号:
10004975 - 财政年份:2020
- 资助金额:
$ 46.87万 - 项目类别:
The Caregiver Outcomes of Alzheimer's Disease Screening (COADS) Trial
阿尔茨海默病筛查 (COADS) 试验的护理人员结果
- 批准号:
10374778 - 财政年份:2018
- 资助金额:
$ 46.87万 - 项目类别:
The Caregiver Outcomes of Alzheimer's Disease Screening (COADS) Trial
阿尔茨海默病筛查 (COADS) 试验的护理人员结果
- 批准号:
9882928 - 财政年份:2018
- 资助金额:
$ 46.87万 - 项目类别: