Care preferences for persons with cognitive impairment: A discrete choice experiment

INTRODUCTION: Evidence is limited on preferences of persons with cognitive decline and their care partners (CPs) regarding care. Our aim was to identify preferences and preference evolution for transitions in supportive care. METHODS: We conducted a discrete choice experiment (DCE) (repeated measures baseline, 6-months) with older adults with mild cognitive impairment or mild to moderate dementia and CPs. Tasks were anchored to health states describing progressive memory and function decline. Split-sample mixed logit models estimated part-worth utilities. RESULTS: Baseline DCEs were completed by 131 cognitively impaired older adults and 137 CPs; 118 and 132 completed 6-month DCEs. At both timepoints, respondents preferred in-home care with moderate support when considering moderate or severe cognitive impairment. As impairment worsened, the acceptability of assisted living increased, especially among CPs. DISCUSSION: Persons with cognitive decline engaged in future-oriented decisions. Preferences were stable across time for both samples, and assisted living was more acceptable for CPs.