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Dementia and Bioethics

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Mental Health and Illness of the Elderly

Part of the book series: Mental Health and Illness Worldwide ((MHIW))

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Abstract

As the life expectancy increases dramatically, the burden of Alzheimer’s disease (AD), the leading cause of dementia, becomes prominent worldwide. With the rapid progress in biomarkers for the pathology of AD, the early diagnosis of AD is possible, and the ethical issue of pre-dementia AD diagnosis has emerged. This chapter discusses the advantages and disadvantages of early diagnosis of pre-dementia AD. The advantages include: provide with appropriate treatment for concomitant diseases, enhance protective factors and control risk factors, alleviate the anxiety of uncertainty by making an accurate diagnosis, plan for the future, and participate in clinical research, contribute to knowledge, and help future generations. The disadvantages include: risks of false-positive or false-negative diagnosis, possible negative emotional effects on the individuals and their families, social stigma of the disease, costs of diagnostic work-up, and additional workload for memory clinics and cognitive research centers. It is the duty of the physicians to recommend whether AD biomarkers are needed as part of the clinical evaluation due to the complexity of the dementia syndrome, and the patient has to decide whether or not to proceed with these tests. Once people decide to be diagnosed early, special communication skills for disclosure are needed followed by education and support.

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Acknowledgments

XL is supported by a fellowship program from Chongqing Medical University and the Medical Research Fund by Chongqing Municipal Health Bureau 20141007 (China).

KN is supported by the National Medical Research Council, Research Training Fellowship Grant (Singapore).

MB is funded by the Yantai Yuhuangding Hospital (China).

SG and PRN are funded by the Canadian Institutes for Health Research.

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Authors and Affiliations

  1. Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Xiaofeng Li

  2. McGill Center for Studies in Aging, 6825 Lasalle Boul, Montreal, QC, H4H 1R3, Canada

    Xiaofeng Li, Kok Pin Ng, Maowen Ba, Pedro Rosa-Neto & Serge Gauthier

  3. National Neuroscience Institute, Singapore, Singapore

    Kok Pin Ng

  4. Department of Neurology, Yuhuangding Hospital Affiliated to Qingdao Medical University, Qingdao, China

    Maowen Ba

Authors
  1. Xiaofeng Li
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  2. Kok Pin Ng
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  3. Maowen Ba
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  4. Pedro Rosa-Neto
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  5. Serge Gauthier
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Corresponding author

Correspondence to Serge Gauthier .

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Editors and Affiliations

  1. The Chinese University of Hong Kong, Tai Po, Hong Kong

    Helen Chiu

  2. Sunnybrook Research Institute, Toronto, Ontario, Canada

    Kenneth Shulman

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Li, X., Ng, K.P., Ba, M., Rosa-Neto, P., Gauthier, S. (2017). Dementia and Bioethics. In: Chiu, H., Shulman, K. (eds) Mental Health and Illness of the Elderly. Mental Health and Illness Worldwide. Springer, Singapore. https://doi.org/10.1007/978-981-10-2414-6_6

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