To the Editor.
—The disclosure of President Reagan's Alzheimer's disease shows the difficulty of early identification and forthright discussion of potential presidential disability from slowly progressive neurologic diseases.Reagan's physicians announced that annual examinations had included "thorough memory testing." They colloquially said that he "is entering the early stages of this disease," ambiguously omitting standardized staging. One physician wrote, "It was only in the past 12 months—six years out of the White House—that his physicians saw clinical signs and results of tests that lead to a diagnosis of Alzheimer's disease. In no way did this disease predate the past year."1 Physician-patient confidentiality is cited to support this vagueness.Such reticence differs from reports of Reagan's other illnesses.2,3 Synopses of the management of a gunshot wound, subdural hematoma, and colon cancer give diagnostic tests, normal baseline data needed to establish trends, standard staging, and an account of medical reasoning.
Miles S. Presidential Disability and the Twenty-fifth Amendment. JAMA. 1995;274(10):798-799. doi:10.1001/jama.1995.03530100037028