Diagnostic disclosure in Alzheimer's disease: A review

Abstract

Although growing, the literature on research into attitudes of general and specialized physicians towards disclosing the diagnosis of dementia and Alzheimer’s disease (AD), or the current practice on AD disclosure, remains limited. Moreover, information is also scarce on what caregivers, or indeed patients themselves, wish to know with regard to their diagnosis. The goal of the present article was to present a review of the current available literature on the topic of truth telling in dementia, especially in AD. The studies discussed in this review were mainly conducted in Europe, particularly in the United Kingdom, as well as the United States. Disclosure of AD diagnosis is not a common practice among physicians. In the clinical context, the discussion on diagnosis disclosure can be valuable for improving the care of AD patients and their families.

Criteria for the diagnosis of Alzheimer's disease: Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology

“…Some medical institutions always advise revealing the diagnosis of demential pictures to patients whenever possible, but cultural, individual and regional factors should be taken into account. 17 …”

“…The percentage of family members of patients with AD who would like to have the diagnosis revealed to the patient ranges from 17 to 76% depending on the country of study. 17 In Brazil, 58% of family members of patients were found to be in favor of revealing the diagnosis, 18 which is routinely done by 44.7% of doctors. 19 Family members and physicians not wishing to reveal the diagnosis more frequently would like such a diagnosis revealed to themselves if they were the patient (90% and 76.8%, respectively).…”

Comunicación diagnóstica en enfermedad de Alzheimer: Reflexión y propuesta

“…Las guías de la Asociación Médica Americana (AMA) recomiendan dar el diagnóstico de Enfermedad de Alzheimer "si es posible" 12 .…”

“…Sin embargo, 72,5% de los médicos respondió que desearía saber el diagnóstico si ellos tuvieran demencia 13 . Otros estudios han mostrado resultados similares 12 .…”

Changes in the use of psychotropic drugs during the course of Alzheimer's disease: A large‐scale longitudinal study of French medical records

“…As a result, general practitioners struggle to diagnose AD with certainty at an early stage 4 and do not refer at‐risk patients to memory clinic specialists 5 , resulting in a late diagnosis. When AD is identified, general practitioners also tend to delay as much as possible its disclosure to the patient 6,7 . Disclosure of diagnosis is made especially difficult by the lack of curative therapeutic options.…”