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Dementia, disclosing the diagnosis

Despite a decline in its incidence rates, increased life expectancy worldwide means that by 2050 over 100 million people will be living with dementia. In the USA alone, a person develops Alzheimer’s disease (AD) every 67 s currently, and this is expected to drop to 33 s by 2050. Physicians, particularly those involved in the care of the older person, should therefore understand the complexities of disclosing a diagnosis of dementia. While many of the general principles of breaking bad news are valid, there are differences in terms of insight and certain cognitive deficits which impact on how clinicians should approach dementia diagnosis disclosure. It is surprising therefore that while numerous published works have discussed formulation of a diagnosis of dementia there is little work to date on how this diagnosis should be disclosed.