ABSTRACT
Alzheimer’s disease gradually impairs not only memory but also executive function (i.e., higher thought processes) of the affected individuals. Executive function is impaired even earlier in dementia. Progressive dementias also lead to development of language impairment that involves comprehension difficulties and speech deficits. These impairments eventually prevent individuals suffering from progressive dementias from making decisions regarding their finances and place of residence and ultimately decisions regarding their medical care. However, development of these impairments is gradual and insidious, and it is not easy to determine when an individual with dementia cannot make a specific decision. It is important to realize that decision-making capacity is decision specific, and individuals with dementia might be still able to make some simple choices while they are unable to make others that are more complicated. For example, the individual may be able to make appropriate choice about the clothes to wear while not understanding the complex issues involved in making decisions regarding medical versus surgical therapy of coronary artery disease.
