Dados do Trabalho

Título

Diagnostic disclosure of Alzheimer’s disease in Brazil: current practice of physicians who diagnose and treat dementia

Resumo

Introduction: Dementia is a syndrome characterized by cognitive and functional decline. In Brazil, the estimated number of individuals with dementia in 2019 was 1.7 million, with an estimate that it will reach 3.7 million in 2050. Legal, ethical and moral issues permeate diagnostic disclosure of Alzheimer’s disease (AD), the main cause of dementia, to patients and families. The right to know the diagnosis, the autonomy of those involved and the principles of non-maleficence and beneficence are mixed with values and attitudes ​​that often do not correlate with bioethical and legal ones. Objective: To investigate the current practice of physicians who diagnose and treat dementia in Brazil. Methods: Observational cross-sectional study. Electronic survey was sent to specialists who are members of the national medical societies of Geriatrics, Neurology and Psychiatry (psychogeriatricians). Results: During 41 days (5/9/2022-6/18/2022), 218 responses were obtained. Of the total, 52.8% are men, whose main medical specialties are Neurology (58.9%), Geriatrics (30.7%), Psychiatry (6.9%), Internal Medicine (1.4%), others (2.1%). These professionals are aged between 26 and 84 years (mean = 46.2 years). The majority (58.7%) of the participants have been following patients with AD for more than 10 years. Concerning the disclosure of the diagnosis of AD, only 16.5% have the habit of always revealing it, 50.9% affirm that they usually do it, 20.6% sometimes, and 11.9% rarely. Despite this, 73.4% of physicians believe that patients, in general, want to know their diagnosis. The reasons why professionals decide to reveal or not the diagnosis of AD to their patients are related to the patient's desire to know it, the opinions of the patient's family about the disclosure, and the severity of dementia, which were indicated by 73.9%, 62.4% and 56.4% of the participants, respectively. On the other hand, 96.3% of physicians would like to know their diagnosis, if they were diagnosed with AD. Of these, 50.9% would like to be better prepared for the future. Conclusions: The diagnostic disclosure of AD by specialized physicians is still not very common in Brazil, which is related to several reasons. More studies and initiatives are necessary to discuss the benefits and harms that diagnostic disclosure can bring and to better understand the demands of patients and families.

Palavras Chave

Dementia; Alzheimer's disease; Diagnostic disclosure.