ABSTRACT
Impairments of decisional capacities and higher order functions are inevitable consequences of Alzheimer’s disease (AD) and related disorders.1,2 As persons with AD experience progressive declines in memory, judgment, reasoning, communication and attention over the course of the disease process, such cognitive changes affect abilities to participate in and perform various higher order capacities (competencies) associated with everyday living.3 Specific capacities which become impaired over time in persons with AD include the capacity to make medical decisions (consent to treatment),1,4,5 consent to research,6
manage finances,7 drive,8,9 make a will10,11 and vote.12,13 Impairment and loss of these capacities significantly reduce patients’ autonomy and psychological well-being,14 cause substantial patient disability and caregiving burden for families and give rise to clinical and legal challenges for clinicians and legal professionals. Thus, loss of competency in AD has important psychological, ethical, clinical and legal implications.3
