Control preferences in treatment decisions among older adults - Results of a large population-based study.
Older adults appear to be a specifically vulnerable group that could benefit considerably from the assessment of their decision-making preferences. The aim of this study was to estimate prevalence rates and to explore characteristics of control preferences in a population-based sample of older adults.



Data was derived from the 8-year follow-up of the ESTHER study - a German epidemiological study in the elderly population. n=3124 participants ages 57 to 84 were visited at home by trained medical doctors for a comprehensive assessment regarding various aspects of their life. The German version of the Control Preferences Scale (CPS) was used to assess decision-making.



Most of the participants reported a preference for an active role in the decision-making process (46%, 95% CI [44.3; 47.9]), while 30.0% [28.4; 31.5] preferred a collaborative role, and 23.9% [22.4; 25.5] a passive role. Participants aged ≤65years preferred a more passive role in decision-making compared to persons aged <65years. Participants with clinically significant depression symptoms (CSD) preferred significantly more often a passive role compared to those without CSD. Similarly, multimorbid patients preferred a passive role compared to people with none or one chronic disease. Conversely, in groups with active or collaborative control preferences the morbidity index was lower compared to the group with passive control preferences.



Results indicate that physical and mental health in the elderly are associated with the preference role. It should, however, be investigated whether multimorbidity or mental diseases influence the treatment preference of older adults.
Department of General Internal Medicine and Psychosomatics, Heidelberg Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. Electronic address: Sabine.Lechner7@gmx.de.
Sabine
S
Lechner
Department of General Internal Medicine and Psychosomatics, Heidelberg Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. Electronic address: Wolfgang.Herzog@med.uni-heidelberg.de.
Wolfgang
W
Herzog
Department of General Internal Medicine and Psychosomatics, Heidelberg Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. Electronic address: Friederike.Boehlen@med.uni-heidelberg.de.
Friederike
F
Boehlen
Department of General Internal Medicine and Psychosomatics, Heidelberg Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. Electronic address: Imad.Maatouk@med.uni-heidelberg.de.
Imad
I
Maatouk
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany. Electronic address: K.Saum@Dkfz-heidelberg.de.
Kai-Uwe
KU
Saum
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany. Electronic address: H.Brenner@Dkfz-heidelberg.de.
Hermann
H
Brenner
Department of General Internal Medicine and Psychosomatics, Heidelberg Medical University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. Electronic address: Beate.Wild@med.uni-heidelberg.de.
Beate
B
Wild
D000368:Aged; D000369:Aged, 80 and over; D000066491:Clinical Decision-Making / Q000379:methods*; D015331:Cohort Studies; D003299:Cooperative Behavior; D003863:Depression / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000379:methods* / Q000523:psychology; D057240:Patient Preference / Q000523:psychology; D010820:Physicians / Q000523:psychology; D011159:Population Surveillance / Q000379:methods; D016896:Treatment Outcome
CPS; Control preferences scale; Decision-making; Elderly; Population-based study