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March 5 - Diagnosis Of Dementia Brings Relief, Not Depression

When it comes to a diagnosis of Alzheimer's disease, what you don't know may not kill you, but knowing the truth as soon as possible appears to be the better approach - one that may improve the emotional well-being of both patients and their caregivers, suggests new research from Washington University in St. Louis.

Medical advances have made it possible to diagnose Alzheimer's at very early stages, but a 2004 review of research found about half of all physicians were still reluctant to inform patients of an Alzheimer's diagnosis. While many physicians fear a dementia diagnosis would only further upset an already troubled patient, this follow-up study found quite the opposite.

"We undertook this study because we wanted there to be some data out there that addressed this question and that we could show to physicians and say, 'Most of the people don't get depressed, upset and suicidal. So, this fear that you have about telling them and disturbing them is probably not legitimate for most people,'" says Brian Carpenter, PhD, associate professor of psychology in Arts & Sciences at Washington University.

In their study, they followed 90 individuals and their caregivers as they came to the Alzheimer's Disease Research Center for an evaluation. Sixty-nine percent eventually got a diagnosis of Alzheimer's disease, but no significant changes in depression were noted and anxiety decreased substantially.

One reason an Alzheimer's diagnosis can be comforting to both family members and patients, suggests Carpenter, is that it provides an explanation for what's been going on with the patient. Caregivers, he notes, are often quick to attribute symptoms of dementia to the person, rather than the disease, and patients wonder if they are going "crazy." This study confirms that most patients, regardless of their degree of impairment, tend to experience a sense of relief after getting their diagnosis.

"We're probably where we were at 10 or 15 years ago with cancer. Years ago when people had cancer their doctors didn't tell them. But we know now that that's improper, and that everybody needs to know if they have cancer. We're going to get there with Alzheimer's disease. [People] are not aware that when you tell the person they're not going to have some sort of catastrophic emotional reaction. The word will get out eventually," says Carpenter.

And there is good reason to spread the word. Earlier diagnoses allow for earlier intervention to delay the effects of Alzheimer's and dementia. Medications currently on the market can delay symptoms in a minor way, in some patients, and may delay institutionalization.

"There are some real practical and financial advantages of even these small incremental gains that we're getting from the medications now. If you can get an extra three to six months in your own house before you have to go to a nursing home, that's a big deal," says Carpenter.

And perhaps more importantly, providing a diagnosis as early as possible gives people a chance to prepare for what is coming. "They know that things are going to get worse rather than better and they know that there's going to come a time when they're not going to be able to do the things they can do now, says Carpenter. "They can get ready for what's coming and we can connect them to support services. We can get their family ready ...so they'll be better prepared."

Source: Washington University in St. Louis

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