Ethical Challenges in the Treatment of Cognitive Impairment in Aging

Abstract

The growing number of individuals with cognitive impairment, ranging from mild cognitive impairment to severe impairment experienced in Alzheimer’s disease and other dementias, has become a pressing public health concern. Ethical issues related to cognitive impairment are salient in research and clinical contexts. Challenges related to the abilities of people with cognitive impairment to provide authentic informed consent or to participate in other safeguard practices meant to assure their rights and well-being are encountered in research and clinical settings. As prevention trials expand in attempts to stave off cognitive decline in individuals with specific risk biomarkers, ethical issues in research design, disclosure of findings, and other concerns at the interface of research and clinical care emerge. Additional ethical issues confront families and clinicians as patients with dementia approach the end of life. This paper reviews recent developments and empirical findings relevant to the ethical dimensions of cognitive impairment in aging, and makes specific recommendations for addressing these issues.