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32/100

✓ Peer-reviewed alzhub usefulness score 32 out of 100. Brain tissue and pathology

Topic: Risk, prevention and care in population studies

People use advance directives to express preferences that direct their future care when they lack decision-making capacity. One form of advance directive, a "dementia directive," records preferences about living in various stages of dementia. This is important because many Americans want to avoid living with advanced progressive dementia. Unfortunately, traditional advance directives cannot dependably achieve this goal. In contrast, some dementia directives can achieve this goal, by directing cessation of manually assisted feeding and drinking.While many dementia directives have been published, most have gaps and omissions that thwart the goal of avoiding extended intolerable life in advanced dementia. To overcome these problems, we formulated a new dementia directive. This article explains the value of this new directive. We proceed in six stages. First, we review the prevalence of advanced dementia. Second, we identify the disadvantages of another option for accomplishing the goal of not living into advanced dementia, preemptive VSED. Third, we distinguish notable court cases where dementia directives were unsuccessful. Fourth, we review nine prominent dementia directives, noting how the Northwest Justice Project's Advance Directive for VSED remedies those shortcomings. Fifth, we review this directive's legal status. Sixth, we articulate its ethical justification.

Key findings

Second, we identify the disadvantages of another option for accomplishing the goal of not living into advanced dementia, preemptive VSED.
Third, we distinguish notable court cases where dementia directives were unsuccessful.
Fourth, we review nine prominent dementia directives, noting how the Northwest Justice Project's Advance Directive for VSED remedies those shortcomings.
Fifth, we review this directive's legal status.
Sixth, we articulate its ethical justification.

Why it matters

This article describes a new dementia advance directive designed to let people document a wish to stop eating and drinking by hand if they reach advanced dementia, addressing gaps in earlier directives. It is a discussion of documentation and ethics, not a study of a treatment, cure or prevention for Alzheimer's disease.

Study details

Evidence strengthLow

How this study scored 32/100

Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 31 of the 96 points we could judge it on, which is 32 out of 100.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (The Journal of Law Medicine & Ethics)
Journal's citation record	1 / 4	The Journal of Law Medicine & Ethics: journal h-index 83 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	4 / 5	2025 — within 3 year(s) of the newest study here
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	0 / 3	Not stated whether this was studied in people — scores zero (not stated in the record — scored 0)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	1 / 7	Cited 2 times (OpenAlex, 2026-10-10)
Citations per year	0 / 5	0.7 citations a year over 3 year(s) since 2025
Impact for its field and year	2 / 6	Cited 1.7× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	0 / 4	Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	— / 4	Senior author's record not available — left out of this score
Institution's track record	0 / 3	Seattle University: institution h-index 167 (OpenAlex)
Multi-centre collaboration	1 / 3	OpenAlex lists 3 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 40994267)
Free to read	2 / 2	Free to read
Points	31 / 96	Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 31 of the 96 points we could judge it on is 32 out of 100.
Total	32 / 100	—

What each of these 20 components measures, and what this score is not →

Read the original

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.

APA 7th

Pope, T. M., Brodoff, L. E., Glass, E. H., Menzel, P. T., & Miller, R. M. (2025). New VSED Advance Directive: Improved Documentation to Avoid Late-Stage Dementia. The Journal of Law Medicine & Ethics. https://doi.org/10.1017/jme.2025.10176

Vancouver

Pope TM, Brodoff LE, Glass EH, Menzel PT, Miller RM. New VSED Advance Directive: Improved Documentation to Avoid Late-Stage Dementia. The Journal of Law Medicine & Ethics. 2025. doi:10.1017/jme.2025.10176. PMID: 40994267.

BibTeX

@article{pope2025-40994267,
  author  = {Pope, Thaddeus Mason and Brodoff, Lisa Ellen and Glass, E. H. and Menzel, Paul T. and Miller, Robb M.},
  title   = {{New VSED Advance Directive: Improved Documentation to Avoid Late-Stage Dementia}},
  journal = {The Journal of Law Medicine \& Ethics},
  year    = {2025},
  doi     = {10.1017/jme.2025.10176},
  pmid    = {40994267},
  url     = {https://doi.org/10.1017/jme.2025.10176}
}

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