MONDAY, Oct. 31, 2016 (HealthDay News) -- More than one-quarter of American seniors have never discussed end-of-life care, a new study finds.

"Despite decades of work to improve advance care planning, over a quarter of older adults have still not engaged in any type of discussion or planning for their end-of-life preferences or plans," said lead author Krista Harrison, a geriatrics research fellow at the University of California, San Francisco.

The researchers looked at more than 2,100 Medicare beneficiaries aged 65 and older. Data from the group included self-reported age, gender, race/ethnicity, education, income, self-rated health, number of chronic conditions, disability in activities of daily living, and dementia.

The researchers found that 60 percent of the beneficiaries said they'd had discussions on end-of-life care, 50 percent on power of attorney, and 52 percent on other advanced directives.

Thirty-eight percent reported discussions on all three elements of advanced care planning, while 27 percent said they hadn't discussed any of the elements.

The rate of discussions on each element varied by as much as 35 percent, depending on patient characteristics. For two or more elements, the rate was lower among those aged 65 to 74, blacks and Hispanics, and those with less education and lower income.

The lowest rate of end-of-life planning was among older Spanish-speaking Hispanics, with 19 percent reporting end-of-life discussion, 20 percent discussing power of attorney and 17 percent discussing advanced directives.

The study also found that older adults with dementia had much lower rates of end-of-life discussions (54 percent) and advance directives (46 percent) than those without dementia (62 percent and 54 percent, respectively).

"Our findings suggest that there are substantial portions of the population of community-dwelling older adults who need to begin discussions about their plans and preferences before they are unable to share those preferences with their loved ones," Harrison said in a university news release.

The study was published Oct. 31 in the journal JAMA Internal Medicine.

More information

The U.S. National Institute on Aging has more about advanced care planning.