Mind over mat­ter

Study: De­men­tia may re­lieve anx­i­ety, de­pres­sion

The Covington News - - Health & Wellness - By Ch­eryl Wittenauer

ST. LOUIS — Doc­tors of­ten hes­i­tate to tell pa­tients they likely suf­fer from Alzheimer’s dis­ease or an­other form of de­men­tia, fear­ing the news will over­whelm them.

But a study by Wash­ing­ton Univer­sity in St. Louis sug­gests physi­cians need not worry.

Not only did the di­ag­no­sis not in­crease anx­i­ety or de­pres­sion among pa­tients and their care­givers, but most were re­lieved to have symp­toms ex­plained and a way to find help.

“It’s not good news. No one is pleased to find out they have de­men­tia,” said Brian Car­pen­ter, co-in­ves­ti­ga­tor and as­so­ci­ate pro­fes­sor of psy­chol­ogy at Wash­ing­ton Univer­sity. “But some peo­ple find com­fort in get­ting res­o­lu­tion to their anx­i­ety and con­cerns, and know­ing that peo­ple can help them.”

The study, which ap­pears in the March is­sue of the Jour­nal of the Amer­i­can Geri­atrics So­ci­ety, gauged de­pres­sion and anx­i­ety two days be­fore and two days af­ter an eval­u­a­tion and di­ag­no­sis.

Med­i­cal prac­tice guide­lines say doc­tors should tell their pa­tients about a de­men­tia di­ag­no­sis re­gard­less of the stage of the dis­ease.

But a re­view of pub­lished stud­ies dat­ing from the 1970s un­til very re­cently showed half of doc­tors were not telling their pa­tients what they sus­pected, the re­searchers said.

Scott Roberts, an Alzheimer’s re­searcher at the Univer­sity of Michi­gan who was not in­volved in the study, said med­i­cal ethi­cists de­bate pa­tients’ right to in­for­ma­tion and the fear that such knowl­edge may up­set them.

“This study is in­ter­est­ing, be­cause it shows a lot of the pa­ter­nal­is­tic fears are not sup­ported by the data,” he said.

Neu­rol­o­gist John Mor­ris, who heads the Alzheimer’s Dis­ease Re­search Cen­ter at Wash­ing­ton Univer­sity where the study sub­jects were eval­u­ated, said doc­tors have vary­ing com­fort lev­els, in part be­cause of un­cer­tainty the di­ag­no­sis is ac­cu­rate.

He said he wanted to eval­u­ate pa­tients’ re­ac­tions be­cause early de­tec­tion has ad­van­tages, such as en­abling pa­tients to plan for their fu­ture care.

In the St. Louis study, 90 pa­tients and their care­givers were in­ter­viewed at the cen­ter two days be­fore the eval­u­a­tion, and by tele­phone two days later. Their lev­els of anx­i­ety and de­pres­sion were gauged based on an­swers to stan­dard­ized ques­tion­naires.

On av­er­age, for both pa­tient and care­giver, anx­i­ety and de­pres­sion lev­els were the same or had de­creased.

The re­searchers ac­knowl­edged that their study has lim­i­ta­tions, and they plan ad­di­tional re­search to ex­pand their in­quiry.

The study gauged the sub­jects’ emo­tional state at only two points in time. A fu­ture study will gauge their re­ac­tions over a year.

And the very set­ting for the study — an Alzheimer’s re­search cen­ter — may have in­flu­enced pa­tients’ and care­givers’ ex­pec­ta­tions, re­searchers said.

Study sub­jects likely re­ceived more in­for­ma­tion and sup­port at the cen­ter than the av­er­age pa­tient does in a pri­mary care doc­tor’s of­fice. Fu­ture stud­ies will look at pri­mary care and neu­rol­ogy and geri­atrics clin­ics.

“It’s a sig­nif­i­cant study for as far as it goes,” said Dr. Greg Sachs, a re­search sci­en­tist at In­di­ana Univer­sity’s Cen­ter for Ag­ing Re­search.

How the di­ag­no­sis is de­liv­ered, and what kind of sup­port is of­fered, may have a lot to do with re­ac­tion, he said.

Sachs cau­tioned that study re­sults should not be used to ar­gue for wider screen­ing of de­men­tia at health fairs and doc­tors’ of­fices. Avail­able treat­ments are ex­pen­sive and only mod­estly help­ful, he added, and many doc­tors are ill-equipped to meet the chal­lenges posed by such pa­tients and their fam­i­lies.

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