Dementia and Bioethics

Abstract

As the life expectancy increases dramatically, the burden of Alzheimer's disease (AD), the leading cause of dementia, becomes prominent worldwide. With the rapid progress in biomarkers for the pathology of AD, the early diagnosis of AD is possible, and the ethical issue of pre-dementia AD diagnosis has emerged. This chapter discusses the advantages and disadvantages of early diagnosis of pre-dementia AD. The advantages include: provide with appropriate treatment for concomitant diseases, enhance protective factors and control risk factors, alleviate the anxiety of uncertainty by making an accurate diagnosis, plan for the future, and participate in clinical research, contribute to knowledge, and help future generations. The disadvantages include: risks of false-positive or false-negative diagnosis, possible negative emotional effects on the individuals and their families, social stigma of the disease, costs of diagnostic work-up, and additional workload for memory clinics and cognitive research centers. It is the duty of the physicians to recommend whether AD biomarkers are needed as part of the clinical evaluation due to the complexity of the dementia syndrome, and the patient has to decide whether or not to proceed with these tests. Once people decide to be diagnosed early, special communication skills for disclosure are needed followed by education and support. (PsycInfo Database Record (c) 2021 APA, all rights reserved)