Prusaczyk Beth, Cherney Steven M, Carpenter Christopher R, DuBois James M
a Washington University School of Medicine , St. Louis , Missouri , USA.
Clin Gerontol. 2017 Jan-Feb;40(1):63-73. doi: 10.1080/07317115.2016.1201714. Epub 2016 Jun 20.
Due to issues related to informed research consent, older adults with cognitive impairments are often excluded from high-quality studies that are not directly related to cognitive impairment, which has led to a dearth of evidence for this population. The challenges to including cognitively impaired older adults in research and the implications of their exclusion are a transdisciplinary issue. The ethical challenges and logistical barriers to conducting research with cognitively impaired older adults are addressed from the perspectives of three different fields-social work, emergency medicine, and orthopaedic surgery. Issues related to funding, study design, intervention components, and outcomes are discussed through the unique experiences of three different providers. A fourth perspective-medical research ethics-provides alternatives to exclusion when conducting research with cognitively impaired older adults such as timing, corrective feedback and plain language, and capacity assessment and proxy appointments. Given the increasing aging population and the lack of evidence on cognitively impaired older adults, it is critical that researchers, funders, and institutional review boards not be dissuaded from including this population in research studies.
由于与知情研究同意相关的问题,认知受损的老年人通常被排除在与认知障碍无直接关系的高质量研究之外,这导致该人群缺乏证据。将认知受损的老年人纳入研究的挑战以及将他们排除在外的影响是一个跨学科问题。从社会工作、急诊医学和骨科手术这三个不同领域的角度探讨了对认知受损老年人进行研究的伦理挑战和后勤障碍。通过三位不同提供者的独特经历,讨论了与资金、研究设计、干预组成部分和结果相关的问题。第四个视角——医学研究伦理——为在对认知受损老年人进行研究时避免排除提供了替代方案,如时间安排、纠正性反馈和平易近人的语言,以及能力评估和指定代理人。鉴于人口老龄化加剧以及缺乏关于认知受损老年人的证据,至关重要的是,研究人员、资助者和机构审查委员会不要因劝阻而不将该人群纳入研究。