title: Capacity to make decisions on medication management in Chinese older persons with mild cognitive impairment and mild Alzheimer's disease.
abstract: BACKGROUND
  This study aimed to assess if decisional capacity and the four decision-making abilities related to decisions concerning medication management were impaired among community-dwelling Chinese older persons in Hong Kong with amnestic mild cognitive impairment (MCI) and mild Alzheimer's disease (AD), as compared with cognitively normal older adults.
  
  
  METHODS
  Two hundred and ninety-one Chinese community-dwelling older adults were recruited. The four decision-making abilities and decisional capacity were assessed by using the Chinese version of the Assessment of Capacity for Everyday Decision-Making (ACED) and independent clinician ratings based on the definition in the UK Mental Capacity Act 2005, respectively.
  
  
  RESULTS
  Ninety-nine participants (34%) were diagnosed with MCI and ninety-five (33%) with mild AD. Although almost all (96%) of the participants in the MCI group were found to be mentally competent to make decisions on medication management in clinician ratings, their decision-making abilities as measured by the ACED were significantly lower than those of the cognitively normal controls.
  
  
  CONCLUSIONS
  Results from this study suggest that abilities related to decisions on medication management are impaired before the clinical diagnosis of dementia is made. Use of specific and structured assessment of the relevant decisional abilities may enhance clinical judgment.
authors.affiliation: Department of Psychiatry, Tai Po Hospital, Hong Kong. victorluiwc@hotmail.com
authors.forename: Victor Wing-Cheong
authors.initials: VW
authors.lastname: Lui
authors.forename: Linda Chiu-Wa
authors.initials: LC
authors.lastname: Lam
authors.forename: Rachel Ching-Man
authors.initials: RC
authors.lastname: Chau
authors.forename: Ada Wai-Tung
authors.initials: AW
authors.lastname: Fung
authors.forename: Billy Mou-Lam
authors.initials: BM
authors.lastname: Wong
authors.forename: Grace Tak-Yu
authors.initials: GT
authors.lastname: Leung
authors.forename: Kwok-Fai
authors.initials: KF
authors.lastname: Leung
authors.forename: Helen Fung-Kum
authors.initials: HF
authors.lastname: Chiu
authors.forename: Jason H T
authors.initials: JH
authors.lastname: Karlawish
authors.forename: Paul S
authors.initials: PS
authors.lastname: Appelbaum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000208:ethnology / Q000523:psychology*; D016022:Case-Control Studies; D002681:China / Q000208:ethnology; D060825:Cognitive Dysfunction / Q000208:ethnology / Q000523:psychology*; D003657:Decision Making; D004358:Drug Therapy / Q000523:psychology*; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D016743:Mental Competency / Q000523:psychology*; D009483:Neuropsychological Tests