Ethical Issues: Perspective 2: The Fundamental Role of Personhood

Abstract

(from the chapter) This chapter discusses bioethical and quality of life issues associated with Alzheimer's disease and related dementias. The syndrome of dementia is an irreversible decline in cognitive abilities that causes significant dysfunction. It is distinguished from "normal age-related memory loss," which affects most people by about age 70 in the form of some slowing of cognitive skills and a deterioration in various aspects of memory. Since 1997, a degree of cognitive impairment that is greater than normal age-related decline but not yet diagnosable as dementia has been labeled "mild cognitive impairment," or MCI, with about a third of those in this category "converting" to dementia each year. Although dementia can have many causes, the primary cause of dementia in our aging societies is Alzheimer's disease (AD). Approximately 60% of dementia in the elderly in the USA is secondary to AD. Without delaying or preventive interventions, the number of people with AD, in the U.S. alone, will increase to 14.3 million by 2050. This discussion will focus on the so-called Alzheimer's dementia in order to illustrate ethical issues that pertain to all progressive dementias. One epidemiological study in the USA estimated that 47% of persons 85 years and older (the "old-old") had probable AD, although this is widely considered an inflated statistic. According to a Swiss study, 10% of nondemented persons between the ages of 85 and 88 become demented each year. Some argue that those who live into their 90s without being affected by AD will usually never be affected by it, but this is still speculative. (PsycINFO Database Record (c) 2013 APA, all rights reserved)