Knowledge of the Brain Death Concept Among Older People B. Febrero a,b , I. Ros b , J. Almela-Baeza c, *, M.B. Pérez-Sánchez d , J.M. Rodríguez a,b , J.J. Ruiz-Manzanera a , F. Alconchel a , L.A. Martínez-Insfran b , J.M. Fernández-Pérez a , L. Martínez-Alarcón a,b , A. Ríos a,b , P. Parrilla a,b , and P. Ramírez a,b a Transplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcian Institute of Biomedical Research, Murcia, Spain; b Department of Surgery, Pediatrics, Gynecology and Obstetrics, University of Murcia School of Medicine, Murcia, Spain; c Faculty of Communication and Documentation, University of Murcia, Murcia, Spain; and the d Department of Statistics, Mathematics and Informatics, University of Miguel Hernández, Elche, Spain ABSTRACT Background. The concept of brain death (BD) is not well understood in the general population; this lack of knowledge is one of the main factors that generates an attitude against organ donation. Older people are a population group that has rarely been studied in relation to organ donation and transplantation (ODT), and it is important to investigate the most important aspects of ODT, such as people’s concept of BD. Objectives. To analyze the level of understanding of the concept of BD in people > 65 years of age and the factors that influence their mode of thinking. Methods. A multicenter study was carried out with a representative sample of people > 65 years of age, stratified by sex and geographic location in the southeast of Spain (n ¼ 420). Knowledge of BD as well as the influence of other variables were analyzed through a validated questionnaire about ODT. SPSS version 21.0 (IBM Corp, Armonk, NY, United States) software was used for statistical analysis. Descriptive analysis included Student t test and the c 2 test. Results. The questionnaire had a completion rate of 84% (n ¼ 351). In 36% (n ¼ 127) of cases, people ˃ 65 years of age understood the concept of BD. In general, knowledge of this concept has not been associated with other variables including social-family interaction about ODT (P > .05). Conclusions. Older people do not understand the concept of BD. It is, therefore, necessary to carry out informative campaigns on ODT explaining this concept. This would improve organ donation awareness in this particular group of people. A lack of understanding regarding the concept of brain death (BD) is one of the main factors that generates an unfavorable attitude toward organ donation [1e4]. This ignorance exists in half of the general population [1], but it can be higher in certain groups [5,6]. Older people repre- sent a growing population in recent years; this has produced an increase in donors and recipients > 65 years of age [7]. Previous studies have shown that this particular group may have a lower predisposition toward organ donation [1]; therefore, it is important to analyze their knowledge about the concept of BD and if there are factors that can influence their knowledge. Our study objective was to analyze peo- ple’s understanding of BD in individuals > 65 years of age and ascertain the influential factors related to organ dona- tion and transplantation (ODT). METHODS An observational sociologic study was performed. A multicenter study was carried out with a representative sample of people > 65 years of age stratified by sex and geographic location in the *Address correspondence to Javier Almela-Baeza, Calle Campus Universitario, 8, 30100 Murcia, Spain. Tel: þ34- 691507629. E-mail: javier.almela@um.es 0041-1345/20 https://doi.org/10.1016/j.transproceed.2019.09.019 ª 2020 Elsevier Inc. All rights reserved. 230 Park Avenue, New York, NY 10169 506 Transplantation Proceedings, 52, 506e508 (2020)