# Improving Shared Decision-Making for Older Adults with Cognitive Impairment: Parkinson's Disease as a Model

> **NIH NIH K76** · UNIVERSITY OF COLORADO DENVER · 2024 · $242,956

## Abstract

PROJECT SUMMARY/ABSTRACT
The purpose of this K76 career development award is to support Dr. Fullard’s long-term career goal of becoming
an independent clinician-scientist focused on improving shared decision-making for older adults with neurologic
disease, including those with mild cognitive impairment (MCI). MCI is common in older adults and can present
unique challenges to shared decision-making. In this proposal, we will examine decision-making in MCI using
Deep Brain Stimulation (DBS) surgery in people with Parkinson’s disease (PD) and MCI as a model. MCI is
common in PD and is especially pertinent to decision-making because it affects executive function, verbal
memory and processing speed, domains that are associated with the ability to weigh risks and benefits and
appreciate the consequences of a decision. In addition, people with MCI exhibit higher decisional conflict and
report more decision regret compared to their healthy counterparts, making this an ideal population for a decision
support intervention. The overall objective of this proposal is to examine the approach to decision-making for PD
patients with MCI and to improve decisional outcomes using a decision aid that addresses cognitive weaknesses.
The central hypothesis is that decisional conflict and decision quality will improve after exposure to the decision
aid. The specific aims for this proposal are to: 1) adapt and refine a DBS decision aid for PD patients with MCI
considering DBS surgery, 2) evaluate the feasibility, acceptability and preliminary effectiveness of the decision
aid for PD patients referred for DBS evaluation, and 3) evaluate implementation of the decision aid guided by
the RE-AIM framework. To achieve these aims, semi-structured interviews will be performed with 30 dyads of
patients with and without MCI and their care partners who have gone through the DBS evaluation process in
order to gain an in-depth understanding of the decision-making process and MCI-specific decisional needs.
Insights from these interviews will be used to adapt and refine our existing DBS decision aid to address cognitive
weaknesses in MCI. A pragmatic, randomized controlled pilot trial will evaluate the feasibility and acceptability
of the decision aid for PD patients undergoing DBS evaluation. The research aims are accompanied by a training
plan designed to address gaps in the candidate’s knowledge and prepare her to become an independent
clinician-scientist and leader in shared decision-making interventions for older adults with neurologic disease.
The training aims for this proposal are to: 1) gain expertise in mixed methods, 2) become proficient in pragmatic
clinical trial design, and 3) gain experience in implementation science. These aims will be achieved through
didactic coursework, workshops, attendance at scientific meetings, practical experience, and direct mentoring.
The candidate is mentored by experts in shared decision-making, mixed methods, neuropsychology, pragmatic
cli...

## Key facts

- **NIH application ID:** 10972735
- **Project number:** 1K76AG083349-01A1
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Michelle Erin Fullard
- **Activity code:** K76 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $242,956
- **Award type:** 1
- **Project period:** 2024-08-16 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10972735

## Citation

> US National Institutes of Health, RePORTER application 10972735, Improving Shared Decision-Making for Older Adults with Cognitive Impairment: Parkinson's Disease as a Model (1K76AG083349-01A1). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10972735. Licensed CC0.

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