Decision-making capacity for informed consent in the older population.

We discuss key concepts and review 12 published research studies relevant to informed consent and decision-making capacity in the older population. The literature suggests that aging is associated with impaired decision-making capacity; the following additional factors amplify the detrimental effect of aging: lower vocabulary level, lower educational level, chronic medical illness (as in nursing home residents), and acute medical illness. Aging may be associated particularly with impaired comprehension of consent forms. We discuss guidelines for clinicians and researchers for improving the process of obtaining a truly informed consent.