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Patients with Mild Alzheimer's Capable of Treatment Decisions

Awareness of their condition is key to competency, study finds

THURSDAY, May 12, 2005 (HealthDay News) -- While people with very mild Alzheimer's disease are likely to be competent enough to make decisions about their treatment, patients with moderate Alzheimer's are no longer able to do so, concludes a study in the May 10 issue of the journal Neurology.

The findings underscore the need for individuals to "consult a doctor if they notice any warning signs of Alzheimer's in themselves or a loved one. An early diagnosis can help assure that patients can participate in decisions about their care," study author Dr. Jason Karlawish, of the University of Pennsylvania in Philadelphia, said in a prepared statement.

The study of 48 people with very mild to moderate Alzheimer's also found that patients who were aware of their diagnosis, symptoms and prognosis were more likely to be able to make competent treatment decisions, regardless of the severity of their disease.

Karlawish and his colleagues interviewed Alzheimer's disease patients and their caregivers. The patients' decision-making abilities were assessed by providing them with information about the benefits and risks of a hypothetical treatment for their disease. The patients were then asked to make a choice about whether they'd like to receive the treatment.

Patients' scores on the Mini-Mental State Examination -- a standard rating scale for cognitive abilities -- can help predict patients' decision-making abilities, the study found. Patients with a score of 11 to 19, which indicates moderate dementia, were not likely to be competent decision-makers. Those with scores of 24 or higher, which indicates very mild dementia, were likely to be competent to make treatment decisions, the experts found.

Patients with mild to moderate Alzheimer's disease with scores of 20 to 23 are in a gray zone and may require more detailed assessment, the researchers said.

More information

The U.S. National Institute on Aging has more about Alzheimer's disease.

SOURCE: Neurology, news release, May 9, 2005
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