Department of Medical Ethics and Health Policy, Perlman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
National Board of Medical Examiners, Philadelphia, PA, USA.
Alzheimers Dement. 2018 Jul;14(7):925-932. doi: 10.1016/j.jalz.2018.01.006. Epub 2018 Mar 27.
Understanding the prevalence of beliefs, attitudes, and expectations about Alzheimer's disease dementia in the public could inform strategies to mitigate stigma.
Random sample of 317 adults from the U.S. public was analyzed to understand reactions toward a man with mild-stage Alzheimer's disease dementia.
In adjusted analyses, over half of respondents expected the person to be discriminated against by employers (55.3%; 95% confidence interval [CI] = 47.0-65.2) and be excluded from medical decision-making (55.3%; 95% CI = 46.9-65.4). Almost half expected his health insurance would be limited based on data in the medical record (46.6%; 95% CI = 38.0-57.2), a brain imaging result (45.6%, 95% CI = 37.0-56.3), or genetic test result (44.7%; 95% CI = 36.0-55.4).
Public education and policies are needed to address concerns about employment and insurance discrimination. Studies are needed to discover how advances in diagnosis and treatment may change Alzheimer's disease stigma.
了解公众对阿尔茨海默病痴呆症的信仰、态度和期望的普遍性,可以为减轻污名化策略提供信息。
对美国公众中的 317 名成年人进行随机抽样分析,以了解他们对患有轻度阿尔茨海默病痴呆症的男性的反应。
在调整后的分析中,超过一半的受访者预计该人将受到雇主的歧视(55.3%;95%置信区间[CI] = 47.0-65.2),并被排除在医疗决策之外(55.3%;95%CI = 46.9-65.4)。近一半的人预计他的健康保险将根据医疗记录中的数据(46.6%;95%CI = 38.0-57.2)、脑部成像结果(45.6%,95%CI = 37.0-56.3)或基因检测结果(44.7%;95%CI = 36.0-55.4)受到限制。
需要进行公众教育和制定政策,以解决对就业和保险歧视的担忧。需要研究如何通过诊断和治疗的进步来改变阿尔茨海默病的污名。