Stability of elderly persons' expressed preferences regarding the use of life-sustaining treatments

The purpose of the study was to assess the stability of expressed preferenc es for the use of life-sustaining treatments (LST) in severe illness condit ions over two years. The two year longitudinal study included three structu red interviews with a one-year interval (1994, 1995, and 1996). At baseline , 1138 Israeli elderly persons (70 +) were interviewed, 802 and 638 were in terviewed in the following stages. Stability over time was assessed on the basis of score differences on two different indices that measured the wish to prolong life. Overall 70% of the respondents had stable preferences for the use of LST ov er time. This result was similar on both indices. The large majority of tho se with stable preferences (86%) did not want to prolong life already in th e baseline interview. This was the most stable group. Among those who chang ed their wishes, the group that wanted LST less at stage 3 (20%) was twice as large as the group that wanted LST more (10%). These findings, which are similar to those reported in a study of an Americ an sample, indicate a high level of stability in elderly persons' expressed preferences for LST at the end of life, and, therefore: strengthen the eth ical basis for using advance directives. They also indicate that elderly pe rsons of different cultural backgrounds may face similar problems regarding the prolongation of life and respond to them similarly. (C) 1999 Elsevier Science Ltd. All rights reserved.