title: Trajectories of preparation for future care among first-degree relatives of Alzheimer's disease patients: an ancillary study of ADAPT.
abstract: OBJECTIVE
  This study examines the longitudinal patterns of Preparation for Future Care (PFC), defined as Awareness, Avoidance, Gathering Information, Decision Making, and Concrete Plans, in first-degree relatives of people with Alzheimer's disease (AD).
  
  
  METHODS
  Eight time points across 6.5 years from a subsample of adults aged 70 years and older who were participating in the Alzheimer's Disease Anti-inflammatory Prevention Trial (ADAPT) were analyzed using latent growth modeling. Baseline attitudes toward planning for future care and demographic variables functioned as predictors in the conditional analyses.
  
  
  RESULTS
  Awareness, Gathering Information, Decision Making, and Concrete Planning increased across time, but Avoidance did not. Covariates were more often associated with the initial levels of planning behavior than with change across time. Women engaged in more initial Decision Making than men. Education was associated with more initial Gathering Information, Decision Making, and less Avoidance. Favorable attitudes toward planning were more predictive of baseline Awareness, Gathering Information, Avoidance, and less so for Decision Making or Concrete Planning.
  
  
  CONCLUSIONS
  Older adults with an elevated risk for AD increase in positive PFC behaviors gradually across time. Demographic characteristics and attitudes predict initial levels of planning, making it possible to identify individuals who might need help progressing to more advanced levels of planning. Future studies are needed to understand rates of change in planning behaviors.
authors: Department of Psychiatry, University of Rochester School of Medicine and Dentistry, 300 Crittenden Boulevard Box Psych, Rochester, NY 14642. wingyun_mak@urmc.rochester.edu.
authors: Wingyun
authors: W
authors: Mak
authors: Silvia
authors: S
authors: Sörensen
mesh_terms: D000328:Adult; D032722:Advance Care Planning; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000451:nursing* / Q000523:psychology; D003657:Decision Making; D005190:Family / Q000523:psychology; D005260:Female; D005544:Forecasting; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009518:New York; D017678:Sex Distribution; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires