Telling patients they have Alzheimer's disease

Important for planning their future, and no evidence of ill effects

Last year Conor et al reported that 83% of family members accompanying patients with Alzheimer's disease to a memory clinic did not want the patients informed of the diagnosis, despite 71% of relatives stating that they would want to be told themselves.1 This finding has stimulated controversy on how doctors should manage this diagnostic information.

In a letter in this week's BMJ, Barnes reports that 57% of first degree relatives in his smaller sample wished their relatives to be informed (p 375).2 Another letter, from Rice et al (p 376), reports a relation between severity of dementia and the self reported behaviour of consultants in the psychiatry of old age: over 80% of psychiatrists responding to a questionnaire stated that they rarely informed severely demented patients. In contrast, they reported nearly always sharing diagnostic information with patients with mild dementia.3 4 Another 40% reported sometimes telling their mildly affected patients. Not surprisingly, practice regarding informing “carers” differed in the opposite direction, with the relatives of more severely affected patients being more …