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How do doctors deliver a diagnosis of dementia in memory clinics?

Dooley, J., Bass, N. & McCabe, R. ORCID: 0000-0003-2041-7383 (2018). How do doctors deliver a diagnosis of dementia in memory clinics?. The British Journal of Psychiatry, 212(4), pp. 239-245. doi: 10.1192/bjp.2017.64


Dementia diagnosis rates are increasing. Guidelines recommend that people with dementia should be told their diagnosis clearly and honestly to facilitate future planning.

To analyse how doctors deliver a dementia diagnosis in practice.

Conversation analysis was conducted on 81 video-recorded diagnosis feedback meetings with 20 doctors from nine UK memory clinics.

All doctors named dementia; 59% (n = 48) approached the diagnosis indirectly but delicately (‘this is dementia’) and 41% (n = 33) approached this directly but bluntly (‘you have Alzheimer's disease’). Direct approaches were used more often with people with lower cognitive test scores. Doctors emphasised that the dementia was mild and tended to downplay its progression, with some avoiding discussing prognosis altogether.

Doctors are naming dementia to patients. Direct approaches reflect attempts to ensure clear diagnosis. Downplaying and avoiding prognosis demonstrates concerns about preserving hope but may compromise understanding about and planning for the future.

Publication Type: Article
Additional Information: This article has been published in a revised form in British Journal of Psychiatry This version is free to view and download for private research and study only. Not for re-distribution or re-use. © The Royal College of Psychiatrists 2018.
Subjects: R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
SWORD Depositor:
[thumbnail of FINAL AUTHOR VERSION Dooley et al_Diagnosis Delivery Paper_BJPsych December 1st.pdf]
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