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Doctors' Attitudes Play Part in Early Alzheimer's Diagnosis

Positive attitude critical to spotting disease, study finds

MONDAY, July 13 (HealthDay News) - A physician's positive attitude towards Alzheimer's is an important factor in early diagnosis of the disease, Australian researchers report.

Because there is no cure for Alzheimer's disease, some doctors don't put much value on early diagnosis of the disease. But that's the wrong outlook, said Dr. Nerida Paterson, senior lecturer in the discipline of general practice at the University of Newcastle.

Early diagnosis enables patients to plan their own health care and future.

"Increasing evidence suggests that early diagnosis of Alzheimer's and timely intervention is beneficial, both for people with the disease and their caregivers," Paterson said in a school news release. "Because doctors are the primary entryway to health-care 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 'therapeutic nihilism' surrounding dementia."

In their ongoing study, Paterson and colleagues found that a doctor's positive attitude about the identification and treatment of dementia is the most important factor in early Alzheimer's diagnosis. They also found that Alzheimer's diagnosis and management is better when doctors have a trusting, personal relationship with people who provide dementia support services.

Referral to support services for legal and financial planning, patient education, and caregiver support is an important part of Alzheimer's management, most of the physicians told the researchers.

Other factors that encourage early diagnosis are: support from relatives and caregivers; belief in the patient's right to know; and the desire of doctors to be honest and open with their patients.

One of the major barriers to early diagnosis is when doctors and patients have different health priorities.

"Older patients frequently have complex and overlapping illnesses involving multiple body systems. Often these diseases are having a bigger impact on their day-to-day lives than mild cognitive impairment. As a result, when they see the doctor, their priority is to have their non-cognitive health needs addressed," Paterson said.

Among the other barriers to early diagnosis: doctors are largely dependent on patients or their relatives to disclose symptoms of memory loss; physicians face challenges with properly timing referral to support services, and they fear damaging the doctor-patient relationship over issues such as telling the patient they're no longer able to drive.

The interim findings were presented July 12 at the Alzheimer's Association's annual meeting in Vienna.

Doctors need to be taught to look out for symptoms of cognitive decline, Paterson and colleagues recommended. They also said they need to offer referrals to support services for dementia patients and caregivers numerous times during the diagnostic and treatment process.

More information

The U.S. National Institute on Aging explains the symptoms and stages of Alzheimer's disease.

-- Robert Preidt

SOURCE: Alzheimer's Association, news release, July 12, 2009

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