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Advance directives and power of attorney for health care in the oldest-old – results of the AgeQualiDe study

Overview of attention for article published in BMC Geriatrics, April 2017
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  • Above-average Attention Score compared to outputs of the same age (64th percentile)

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6 tweeters


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83 Mendeley
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Advance directives and power of attorney for health care in the oldest-old – results of the AgeQualiDe study
Published in
BMC Geriatrics, April 2017
DOI 10.1186/s12877-017-0482-8
Pubmed ID

Tobias Luck, Francisca S. Rodriguez, Birgitt Wiese, Carolin van der Leeden, Kathrin Heser, Horst Bickel, Jürgen in der Schmitten, Hans-Helmut Koenig, Siegfried Weyerer, Silke Mamone, Tina Mallon, Michael Wagner, Dagmar Weeg, Angela Fuchs, Christian Brettschneider, Jochen Werle, Martin Scherer, Wolfgang Maier, Steffi G. Riedel-Heller


Completion of advance directives (ADs) and power of attorney (POA) documents may protect a person's autonomy in future health care situations when the individual lacks decisional capacity. As such situations become naturally much more common in old age, we specifically aimed at providing information on (i) the frequency of ADs/POA in oldest-old individuals and (ii) factors associated with having completed ADs/POA. We analyzed data of oldest-old primary care patients (85+ years; including community-dwelling and institutionalized individuals) within the German AgeQualiDe study. Patients were initially recruited via their general practitioners (GPs). We calculated frequencies of ADs and POA for health care with 95% confidence intervals (CI) and used multivariable logistic regression analysis to evaluate the association between having ADs and POA and participants' socio-demographic, cognitive, functional, and health-related characteristics. Among 868 GP patients participating in AgeQualiDe (response = 90.9%), n = 161 had dementia and n = 3 were too exhausted/ill to answer the questions. Out of the remaining 704 (81.1%) dementia-free patients (mean age = 88.7 years; SD = 3.0), 69.0% (95%-CI = 65.6-72.4) stated to having ADs and 64.6% (95%-CI = 61.1-68.2) to having a POA for health care. Individual characteristics did not explain much of the variability of the presence/absence of ADs and POA (regression models: Nagelkerke's R(2) = 0.034/0.051). The most frequently stated reasons for not having ADs were that the older adults trust their relatives or physicians to make the right decisions for them when necessary (stated by 59.4% and 44.8% of those without ADs). Among the older adults with ADs, the majority had received assistance in its preparation (79.0%), most frequently from their children/grandchildren (38.3%). Children/grandchildren were also the most frequently stated group of designated persons (76.7%) for those with a POA for health care. Our findings suggest a high dissemination of ADs and POA for health care in the oldest-old in Germany. Some adults without ADs/POA perhaps would have completed advance care documents, if they had had received more information and support. When planning programs to offer advanced care planning to the oldest old, it might be helpful to respond to these specific needs, and also to be sensitive to attitudinal differences in this target group.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 83 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 83 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 13 16%
Student > Bachelor 11 13%
Researcher 10 12%
Student > Doctoral Student 8 10%
Student > Ph. D. Student 7 8%
Other 17 20%
Unknown 17 20%
Readers by discipline Count As %
Medicine and Dentistry 18 22%
Nursing and Health Professions 16 19%
Psychology 10 12%
Social Sciences 7 8%
Engineering 3 4%
Other 11 13%
Unknown 18 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 June 2017.
All research outputs
of 16,682,934 outputs
Outputs from BMC Geriatrics
of 1,978 outputs
Outputs of similar age
of 271,290 outputs
Outputs of similar age from BMC Geriatrics
of 1 outputs
Altmetric has tracked 16,682,934 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 1,978 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 10.0. This one is in the 43rd percentile – i.e., 43% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 271,290 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 64% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them