Benefits and Burdens of Screening Oldest-old Women: the Case of Mammography

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DESCRIPTION (provided by applicant): As life expectancy increases, more women are living into their 80's and 90's and many clinicians are now caring for many healthy Independent older women. Identifying which of these women may benefit from different health promotion measures is challenging and data are needed on outcomes of several of these measures for the oldest adults to Inform and Improve medical decision-making. One area where decision- making is complicated due to limited data on benefits and risks is the case of mammography screening for women aged 80 and older. This proposal aims to collect more data on mammography screening among women aged 80 and older and to design tools to help with decision-making. In the future, Dr. Schonberg plans to use the skills she obtains from this career development award to explore the benefits and risks of other health promotion measures for older adults and design tools to improve decision-making around these measures. The first project in this proposal is a longitudinal observational study to describe the psychological impact and the decision-making process of 75 women aged 80 and older compared to 75 women aged 65-79 after an abnormal mammogram. For the second project, Dr. Schonberg plans to use data she collects in her first project as well as data she has previously collected to design and evaluate a decision aid on mammography screening for women aged 80 and older and their clinicians. Through coursework, seminars, and the development and completion of these rigorous studies, Dr. Schonberg plans to enhance her methodological skills and understanding of the decision sciences; to develop expertise In psychometric testing and designing and assessing decision aids; to learn how to design randomized control trials for testing the efficacy of decision aids in future studies; and to further her education in geriatric principles and medicine. Dr. Schonberg's long-term career goal is to become a skilled and established independent investigator in the area of improving decision-making around health promotion for older adults. The Beeson Career Development Award in Aging will allow Dr. Schonberg to acquire additional research skills and expertise and to collect data to help with decision-making around screening for older women. RELEVANCE: The population of women 80 and older is increasing, with little information to help them make decisions about screening mammography. Some women aged 80 and older may benefit from screening while others in poor health are unlikely to benefit due to limited life expectancy. This proposal will collect data to design a decision aid to help with decision-making around mammography screening for women 80 and older.