# Adapting supported decision making to promote wellbeing and improve health outcomes for persons living with Alzheimer's disease and Alzheimer's disease related dementias

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $696,965

## Abstract

Project Summary/Abstract:
Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) relentlessly erode affected
individuals' decision-making abilities. As these abilities decline, persons with AD/ADRD often engage another
person, typically their care partner, in decision making. In clinical encounters, the addition of a third party, the
clinician, further complicates communication and decision making. There is a critical need to identify
interventions with the potential to improve dyadic and triadic communication. Supported decision making is
such an intervention. In supported decision making, an adult with impaired decisional abilities enters into a
structured agreement with another person; this agreement identifies domains in which the adult with impaired
decisional abilities needs and wants decision-making help, and it specifies the kinds of help sought. This
agreement then guides the supported decision-making process. For example, based on the agreement, this
other person may talk through the pros and cons of various treatment options to aid the adult with impaired
decisional abilities in reaching a decision. Supported decision making acknowledges the potential
vulnerabilities of persons with impaired decisional abilities while also promoting their ability to engage in self-
determination and, in turn, their wellbeing. Supported decision making is increasingly being used with young
adults with intellectual and developmental disabilities (I/DD) who reach the age of majority (i.e., are no longer
minors under parental care), and evidence suggests that supported decision making promotes their wellbeing.
Moreover, many states are beginning to recognize supported decision making as an option for persons with
impaired decisional abilities. Yet, no extant supported decision-making resources are AD/ADRD-specific, and
there is a lack of evidence on the outcomes of supported decision making for persons with AD/ADRD, their
care partners, or clinicians. In Aim 1, we will modify existing supported decision-making tools for use in
AD/ADRD with input from Delphi panelists including patients, care partners, clinicians, and experts in consent,
capacity, and supported decision making. In Aim 2, we will interview patients, care partners, and clinicians to
understand the attitudinal, normative, and self-efficacy beliefs associated with greater intention to use the
AD/ADRD-specific supported decision-making toolkit, as well as perceived barriers to its use. In Aim 3, we will
pilot test the AD/ADRD-specific supported decision-making toolkit with patients, care partners, and clinicians at
the Penn Memory Center and assess decision making following delivery of the intervention relative to usual
care. In order to develop potent, scalable behavioral interventions to meet the medical decision-making needs
of the millions of Americans with AD/ADRD, we must increase our understanding of the mechanisms
underlying supported decision making and assess its abili...

## Key facts

- **NIH application ID:** 10847463
- **Project number:** 5R01AG077111-03
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Emily Largent
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $696,965
- **Award type:** 5
- **Project period:** 2022-06-01 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10847463

## Citation

> US National Institutes of Health, RePORTER application 10847463, Adapting supported decision making to promote wellbeing and improve health outcomes for persons living with Alzheimer's disease and Alzheimer's disease related dementias (5R01AG077111-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10847463. Licensed CC0.

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