The role of cognitive impairment in desire for hastened death: A study of patients with advanced AIDS Journal Article


Authors: Pessin, H.; Rosenfeld, B.; Burton, L.; Breitbart, W.
Article Title: The role of cognitive impairment in desire for hastened death: A study of patients with advanced AIDS
Abstract: To examine the relationship between cognitive impairment and desire for death in patients with advanced AIDS we evaluated 128 patients with advanced AIDS consecutively admitted to three long-term care facilities. Participants completed a clinical assessment that included a self-report measure of desire for hastened death in the medically ill (Schedule of Attitudes toward Hastened Death), three measures of cognitive functioning designed to screen for cognitive impairment (Dementia Rating Scale, Mini-Mental State Exam, HIV Dementia Scale), and other measures of physical and psychological functioning. Participants who were classified as cognitively impaired obtained significantly higher scores on the measure of desire for death than did patients without cognitive impairment. This modest association between cognitive impairment and desire for death remained significant even after controlling for the impact of depression on desire for death. Specific aspect of cognitive functioning such as memory and psychomotor coordination appeared to be more salient than executive functioning or abstract reasoning. Cognitive impairment appears to have a modest, but significant impact on patients' desire for hastened death. Aggressive treatment of cognitive symptoms in the terminally ill is necessary in order to disentangle the various factors that may drive end-of-life treatment decisions. © 2003 Elsevier Inc. All rights reserved.
Keywords: adult; controlled study; aged; major clinical study; disease course; medical decision making; prevalence; medical assessment; questionnaires; depression; death; severity of illness index; scoring system; neuropsychological tests; cognition; rating scale; cognitive defect; acquired immune deficiency syndrome; acquired immunodeficiency syndrome; cognition disorders; memory; hiv; attitude to death; health care facility; mini mental state examination; aids; end-of-life; cognitive impairment; desire for hastened death; psychomotor activity; treatment decisions; humans; human; male; female; article
Journal Title: General Hospital Psychiatry
Volume: 25
Issue: 3
ISSN: 0163-8343
Publisher: Elsevier Science, Inc.  
Date Published: 2003-05-01
Start Page: 194
End Page: 199
Language: English
DOI: 10.1016/s0163-8343(03)00008-2
PUBMED: 12748032
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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MSK Authors
  1. William S Breitbart
    346 Breitbart
  2. Hayley Ann Pessin
    70 Pessin