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screen-for-dementia

Doctors Don’t Screen for Dementia During Routine Check-Ups

By | March 5th, 2019

When seniors go to a doctor’s office, they get a routine wellness exam that includes checking their height and weight, blood pressure and an ear and eye examination.

But doctors often do not check for something that one in 10 seniors will face by the time they turn 65: Alzheimer’s disease.

On Tuesday, the Alzheimer’s Association released an annual report that showed only 16 percent—one in seven—of older adults receives regular cognitive assessments at the doctor’s office.

Almost all seniors surveyed (94 percent) said they had seen a personal care physician for a regular exam in the past year, but less than half (47 percent) said the topic of thinking or memory problems came up. A little less than third (28 percent) said they had ever been assessed for problems with cognition.

On the other hand, seniors are routinely examined for risk factors that might lead to more serious health problems like diabetes or heart disease, for which prevention is an absolutely necessary precaution.

“[This] stands in sharp contrast to regular screening or preventive services for other health factors: blood pressure (91 percent); cholesterol (83 percent), vaccinations (80 percent), hearing or vision (73 percent), diabetes (66 percent) and cancer (61 percent),” wrote the report authors.

As patients age, Alzheimer’s disease only becomes more prevalent. Three percent of people age 65-74, 17 percent of people age 75-84, and 32 percent of people age 85 and older have Alzheimer’s dementia, according to research from the 2010 U.S. Census.

An early diagnosis of Alzheimer’s that might be caught by asking a patient or family member a few questions could translate to huge savings for patients and the medical system, according to the Alzheimer’s Association. “If all individuals who were alive in 2018 and will develop Alzheimer’s disease were diagnosed during the MCI stage, $7.9 trillion could be saved,” according to the report.

Early detection allows for patients to plan for the future, participate in activities that might help preserve their cognitive function (like quitting smoking or increasing exercise) and enroll in any clinical trials that might benefit them (and future Alzheimer’s patients).

And while 93 percent of doctors said patients either benefit or are not harmed by early detection of cognitive impairment, more than half said that patient resistance to cognitive testing stopped them from giving an assessment.

Even though 51 percent of seniors surveyed said they notice changes in their cognition, just 15 percent said they bring up their memory concerns to their doctor on their own. Four out of five seniors said memory assessment should be a normal part of the check-up.

Both doctors and patients rank cognitive testing as important, but that belief is not translating to everyday care.

However, the scientific community is taking notice that tests for early detection of cognitive problems—along with the physical signs of Alzheimer’s in the brain, which appear long before symptoms—are an important part of the fight against Alzheimer’s. Over the last few years, research into everything from a smell test for Alzheimer’s to a tool that looks deep into the eyes for beta-amyloid plaques has shown promise. Researchers have seen that the way a person walksspeaks or drives might be able to raise the red flag for dementia. Bill Gates is funding something called the Diagnostics Accelerator, committing $30 million to the search for a “reliable, affordable, and accessible diagnostic.”

Screening for cognitive problems can be as easy as asking the person closest to the patient if they’ve noticed any changes in their loved one, according to William Burke, M.D., of the Banner Alzheimer’s Institute. “Your best baseline is your social network,” Burke told Being Patient, adding that people concerned about their memory should ask their closest friend or relative if they’re different than they were a year ago, or if there are things you could do a year ago that you cannot do now.

[ Next: Cognitive Tests Could Be Key to Early Alzheimer’s Diagnosis ]

One thought on “Doctors Don’t Screen for Dementia During Routine Check-Ups

  1. I am 89 and healthy with no signs of dementia and I live alone. By California law, Drs are required to report any memory problems to the DMV with a likely loss of ones driver license. I understand the benefit of this law, but for me it would be a death sentence since I will never choose to be forced into dependent living upon losing said license. Loss of license with dementia is desirable, but not so with just the existence of simple short term memory difficulties and some drs will report said info without considering the functional totality.

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