Cecily O'Connor
RedwoodAge.com
Early diagnosis of Alzheimer's is highly beneficial for adults with the disease, but many general practitioners shy away from making that call.
The trouble is that less than 35 percent of people with Alzheimer's disease or other dementias have a diagnosis of the condition in their medical record.
Because there is currently no cure for Alzheimer's, some doctors are simply stalled by a belief that treatment isn't important, according to researchers attending the Alzheimer's Association International Conference on Alzheimer's Disease in Vienna.
In fact, early detection and diagnosis gives patients a big leg up in the ability to plan their own healthcare - and future.
"By getting diagnosed late in the progression of the disease, opportunities are missed to make key decisions about treatment, care and future planning," said Dr. William Thies, chief medical and scientific officer at the Alzheimer's Association. "Being diagnosed early is vital to receiving the best help and care possible, living one's life to the fullest and capitalizing on opportunities such as participating in clinical studies."
Most recently, a research institute devoted to Alzheimer's teamed up with a major maker of diagnostic tests to develop what could be the first test to detect Alzheimer's in its early stages. However, this is only one side of the equation. Improved communication among doctors and their patients also needs analysis.
Therapeutic Nihilism
That's why Dr. Nerida Paterson, senior lecturer in the discipline of general
practice at the University of Newcastle, Australia, has been interviewing more
than 100 general practitioners from four Australian research sites, looking for
insights that can improve the diagnostic process. At the conference, Paterson
reported an interim analysis, including interviews with 25 general
practitioners.
"Because doctors are the primary entry way to healthcare services for the elderly and the usual point of contact with the health system for individuals with dementia and their caregivers, there remains a need to overcome their attitudes of 'therapeutic nihilism' surrounding dementia," Paterson said.
So-called therapeutic nihilism is a belief that there is no recognized cure or effective treatment for an illness, and therefore treatment or intervention in any form is not important, Paterson said.
According to researchers, the most common barriers to a dementia diagnosis are: patients and physicians have differing health priorities and physicians are largely dependent on being alerted by either the patient or a relative about memory loss symptoms.
Doctors also expressed a fear of damaging the doctor-patient relationship, especially around the issue of declaring one's inability to drive safely.
Support Networks
Conversely, a doctor's positive attitude can significantly influence early
diagnosis and treatment of dementia. In addition, physicians reported that
having a trusting, personal relationship with individuals who provide dementia
support services is a critical to dementia diagnosis and management.
Most of the physicians said that a referral to support services for legal and financial planning, patient education, and caregiver support is also an important part of disease management.
Additional factors that encourage early Alzheimer's diagnosis include: support from relatives and caregivers, belief in the patient's right to know, and the desire of physicians to be honest and open with their patients.
Overall, the researchers recommend that doctors maintain a higher level of suspicion for symptoms of cognitive decline.
In addition, physicians should offer referrals to support services for people with dementia and caregivers on multiple occasions during the diagnostic and treatment process.
