How can physicians empathetically deliver a diagnosis that reflects the evolving landscape of Alzheimer's disease care: A scoping review.

Abstract

Communicating an Alzheimer's disease (AD) diagnosis requires physicians to navigate not only complex symptoms but also profound psychosocial challenges influencing family dynamics and long-term neuropsychiatric care planning. The research landscape of AD has undergone a rapid transformation, marked by disease-modifying therapies such as lecanemab and donanemab. This study examines physician practices in AD diagnostic disclosure, clinician training for these conversations, and adaptations to emerging disease-modifying therapies. A structured scoping review was conducted using PubMed, PsycINFO, and Web of Science. The review focused on three themes: (1) best practices in diagnostic disclosure, (2) barriers to effective communication, and (3) physician training. A survey of neurologists and psychiatrists at the Renaissance School of Medicine is underway to assess their perspectives on discussing disease-modifying therapies with patients. The database search identified 337 records; after duplicates were removed, 245 were screened, 66 full texts assessed, and 23 studies included. Physicians emphasized the importance of helping patients maintain a sense of control, offering practical advice, and connecting patients to health and social intervention services. Physicians reported low confidence in conveying uncertainty, describing tension between honesty about limitations and preserving hope. With few formal opportunities, physicians rely on peers or supplemental resources to refine communication strategies. The scoping review found few studies on novel therapies' impact on diagnostic conversations and no formal guiding frameworks. This gap highlights the need to investigate physicians' approaches to discussing disease-modifying therapies for AD, which forms the basis of ongoing research.