Association of domain-specific cognitive functions with decision-making capacity in elderly individuals with cognitive impairment

Background Population aging and rising cognitive impairment prevalence are global challenges for healthcare systems. We investigated the association of domain-specific cognitive functions with decision-making capacity of everyday activities and medical treatment. Methods Cross-sectional data were collected from 457 older adults with cognitive impairment. Cognitive functions were assessed by The Montreal Cognitive Assessment. Chinese version of the Assessment of Capacity for Everyday Decision-making abilities and the MacArthur Competency Assessment Tool for Treatment were used to assess the decision-making capacity of medication management and treatment. Multiple linear regression was conducted to analyze the association of domain-specific cognitive functions with decision-making capacity. Results Cognitive domains accounted for 30.1%ཞ67.4% of the variance in decision-making capacities in multivariate models. Attention and language abilities consistently emerged as the strongest predictors across all four domains of decision-making capacities for both medication management and treatment. Visuospatial and executive abilities and orientation showed significant effect on understanding and appreciation in both decision context. Abstract thinking and delayed recall were non-significant in the models of both decision-making capacities. Conclusions This study provides insights into the association of two key factors (cognitive function and decision-making capacity) for involving people with cognitive impairment into decision-making for themselves to promote quality of long-term care. Clinical trial number: Not applicable.