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Study evaluates Alzheimer's patients' ability to make decisions about treatment

ST. PAUL, Minn. People with very mild Alzheimer's disease are still competent to make decisions about their treatment, while those with moderate Alzheimer's may no longer be able to competently make those decisions, according to a study published in the May 10 issue of Neurology, the scientific journal of the American Academy of Neurology. The study also found that people who were aware of their Alzheimer's diagnosis, symptoms, and prognosis were more likely to be able to make competent decisions, regardless of the severity of their disease.

"These results are yet another reason why people should consult a doctor if they notice any warning signs of Alzheimer's in themselves or a loved one," said study author Jason Karlawish, MD, of the University of Pennsylvania in Philadelphia. "An early diagnosis can help assure that patients can participate in decisions about their care."

For the study, researchers interviewed 48 people with very mild to moderate Alzheimer's disease and 102 caregivers of people with mild to severe Alzheimer's. The patients' decision-making abilities were measured by giving them information about the benefits and risks of a hypothetical treatment for Alzheimer's and asking them to make a choice whether they would take the treatment. Then experts assessed whether they were competent to make the decision.

Of the 48 patients, 19 were found to be competent in making the decision.

The study found that scores on the Mini-Mental State Examination (MMSE), a widely used rating scale for cognitive abilities, can help predict patients' decision-making abilities. Those with scores of 11 to 19 on the scale, which indicates moderate dementia, were not likely to be competent decision-makers. Those with scores of 24 and higher, which indicates very mild dementia, were likely to be competent decision-makers.

Those with scores of 20 to 23, with mild to early moderate Alzheimer's, are in a gray zone, Karlawish said. "If there
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Contact: Robin Thompson
rthompson@aan.com
651-695-2763
American Academy of Neurology
9-May-2005


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