Attitudes about physician-assisted death vary among patients with Alzheimer disease, according to a study published in JAMA Neurology.
Researchers evaluated patients from the Anti-Amyloid Treatment In Asymptomatic Alzheimer’s Disease study (NCT02008357) and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration study (NCT02488720) for their attitudes about physician-assisted death. The Anti-Amyloid Treatment In Asymptomatic Alzheimer’s study consisted of individual with elevated amyloid-β, whereas the Longitudinal Evaluation of Amyloid Risk and Neurodegeneration study consisted of individuals with normal levels of amyloid-β. Patients were interviewed 12 months after completing an initial interview and learning their amyloid-β levels.
Among the elevated amyloid-β cohort (n=50), 50% were women, 80% had a family history of Alzheimer disease, and 30% were ≥75 years old. In the normal amyloid-β cohort (n=30), 57% were women, 70% had a family history of Alzheimer disease, and 17% were ≥75 years old. Nearly two-thirds of individuals in the elevated amyloid- β cohort stated they have not thought about and would not consider a physician-assisted death. One out of 5 in the elevated amyloid- β cohort stated they would consider a physician-assisted death if they were cognitively impaired, suffering, or burdening others. In the normal amyloid-β cohort, several patients stated they would consider physician-assisted death if their amyloid-β levels were elevated.
Study authors point out using only 2 study populations, and not inquiring about other end-of-life preferences may have served as limitations to this study.
The researchers concluded that “[u]nderstanding attitudes toward [physician-assisted death] held by individuals at risk for cognitive decline owing to [Alzheimer disease] is important to inform ongoing debates about the scope of access to [physician-assisted death].”
The Anti-Amyloid Treatment In Asymptomatic Alzheimer’s study was sponsored by Eli Lilly and Company. Dr. Largent and Dr. Karlawish report funding from organizations and pharmaceutical companies. Please see the original reference for a full list of authors’ disclosures.
Largent EA, Terrasse M, Harkins K, Sisti DA, Sankar P, Karlawish J. Attitudes toward physician-assisted death from individuals who learn they have an Alzheimer disease biomarker [published online April 29, 2019]. JAMA Neurol. doi:10.1001/jamaneurol.2019.0797