As physicians continue working later in life, health systems are confronted with a complex problem: How do you protect patients from physicians who develop Alzheimer’s disease or other forms of cognitive impairment while not unfairly penalizing those who are still competent?

Gayatri Devi, MD, tackled this subject in a perspective published March 22 in The New England Journal of Medicine.

She said it is important to erase the stigma of Alzheimer’s disease and understand the variability of cognitive decline on the individual level. Physicians shouldn’t be immediately shunned at the first mention of Alzheimer’s, she wrote.

“Patients with preclinical Alzheimer’s—whose brains may be riddled with plaques and tangles—may live into their 90s without discernible symptoms,” wrote Devi, a clinical professor of neurology at SUNY Downstate Medical Center.

Extrapolating data from the general population aged 70 and older, Devi estimated about 4,600 actively licensed physicians in that age group have Alzheimer’s, 6,460 have any type of dementia and another 20,000 have mild cognitive impairment.

The author said it is reasonable to test baseline cognitive function in health professionals at age 60, 10 years before the American Medical Association currently suggests. She said regular cognitive evaluations could be added to periodic testing for specialty-specific skills that are already used to maintain certifications.

Read the full paper at the link below.