{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:05:38Z","timestamp":1792112738518,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K24AG054415"],"award-info":[{"award-number":["K24AG054415"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>To determine whether depression and anxiety are associated with advance care planning (ACP) engagement or values concerning future medical care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Cross\u2010sectional.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>English\u2010 and Spanish\u2010speaking patients, aged 55\u2009years and older, from a San Francisco, CA, county hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASURES<\/jats:title>\n                    <jats:p>Depression was measured by the Patient Health Questionnaire 8\u2010item scale, and anxiety was measured by the Generalized Anxiety Disorder 7\u2010item scale, using standardized cutoffs of 10 or more for moderate\u2010to\u2010severe symptoms. ACP engagement was measured using validated surveys of ACP behavior change (e.g., self\u2010efficacy and readiness; mean five\u2010point Likert score) and ACP actions (e.g., ask, discuss, and document wishes; 0\u2010 to 25\u2010point scale), with higher scores representing higher engagement. In addition, we asked a question about valuing life extension (\u201csome health situations would make life not worth living\u201d). We used adjusted linear and logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Mean age of 986 participants was 63\u2009years, 81% were non\u2010White, 39% had limited health literacy, 45% were Spanish speaking, 13% had depression, and 10% had anxiety. After adjustment for demographic and health status variables, participants who were depressed versus not depressed had higher ACP behavior change scores (0.2 points; 95% confidence interval (CI) = 0.06\u20130.38;\n                      <jats:italic>P<\/jats:italic>\n                      = .007), higher ACP action scores (1.5 points; 95% CI = 0.51\u20132.57;\n                      <jats:italic>P<\/jats:italic>\n                      = .003), and higher odds of not valuing life extension (odds ratio (OR) = 2.5; 95% CI = 1.5\u20134.3;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Results were similar in participants with versus without anxiety (ACP behavior change: 0.2 points; 95% CI = 0.05\u20130.40;\n                      <jats:italic>P<\/jats:italic>\n                      = .01; ACP action scores: 1.2 points; 95% CI = 0.14\u20132.32;\n                      <jats:italic>P<\/jats:italic>\n                      = .028; odds of not valuing life extension: OR = 2.3; 95% CI = 1.3\u20133.9;\n                      <jats:italic>P<\/jats:italic>\n                      = .004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Depression and anxiety were associated with greater ACP engagement and not valuing life extension. Although the direction of association between ACP engagement and values with anxiety and depression cannot be determined in this cross\u2010sectional study, these conditions may influence ACP preferences. Future studies should assess whether changes in anxiety or depression affect ACP preferences over time.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.16754","type":"journal-article","created":{"date-parts":[[2020,8,12]],"date-time":"2020-08-12T00:08:25Z","timestamp":1597190905000},"page":"2638-2642","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Anxious, Depressed, and Planning for the Future: Advance Care Planning in Diverse Older Adults"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5572-0513","authenticated-orcid":false,"given":"Ryan D.","family":"McMahan","sequence":"first","affiliation":[{"name":"School of Medicine University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah E.","family":"Barnes","sequence":"additional","affiliation":[{"name":"San Francisco Veterans Affairs Health Care System  San Francisco California USA"},{"name":"Department of Psychiatry University of California, San Francisco  San Francisco California USA"},{"name":"Department of Epidemiology and Biostatistics University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine S.","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Division of Palliative Care and Geriatric Medicine, Department of Medicine Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengshi","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Shi","sequence":"additional","affiliation":[{"name":"San Francisco Veterans Affairs Health Care System  San Francisco California USA"},{"name":"Department of Epidemiology and Biostatistics University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"David","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan J.","family":"Walker","sequence":"additional","affiliation":[{"name":"Rory Meyers College of Nursing New York University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria L.","family":"Tang","sequence":"additional","affiliation":[{"name":"San Francisco Veterans Affairs Health Care System  San Francisco California USA"},{"name":"Department of Psychiatry University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca L.","family":"Sudore","sequence":"additional","affiliation":[{"name":"San Francisco Veterans Affairs Health Care System  San Francisco California USA"},{"name":"Department of Psychiatry University of California, San Francisco  San Francisco California 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