Identifying memory difficulties and cognitive issues—although it can be a frightening prospect—is the first step toward treatment.
Dementia is progressive, yet many older adults never get screened
Dementia—a syndrome that impacts memory, thinking, and behavior—is a symptom of other medical issues (i.e., Alzheimer’s, vascular issues, and depression, among others) and is sometimes treatable. That is, if it’s caught before the underlying illnesses progress too far.
Despite this, a study published in November 2014 found that most people with dementia had never seen a physician about their confusion.
Approximately 1.8 million Americans over the age of 70 with dementia have never had an evaluation of their cognitive abilities. Yet early evaluation and identification of people with dementia may help them receive care earlier,
said Vikas Kotagal, MD, MS, of the University of Michigan Health System in Ann Arbor.
Researchers from the Indiana University Center for Aging Research and the Regenstrief Institue, led by Nicole Fowler, Ph.D., are in the process of teasing out what factors help motivate people to get screened for dementia. According to Fowler,
Despite rising incidence rates of Alzheimer's and other dementias, many individuals with cognitive impairment are not screened. They go unrecognized and thus never receive evaluation or diagnosis. Understanding patients' attitudes about the risk and benefits of early identification of dementia is vital as we evaluate potential screening barriers and facilitators.
In a recent study, published in the peer-reviewed Journal of Aging Research, Fowler's team found that 63 percent of adults over the age of 65 were willing to be screened by phone. The willingness to participate in phone screening was consistent among those surveyed, regardless of age, sex, or race.
While this result was a surprise to researchers, it was significantly lower than the nearly 90 percent of older adults who agreed to face-to-face screenings in a study the team conducted in 2012. However, the press release notes that phone screening could be less burdensome to patients, who would otherwise have to make doctors’ appointments, and drive or find rides into their physician’s offices for screening.
Interestingly, willingness to be screened was based on the same beliefs, regardless of the screening method (i.e., in-person, or by phone). The research indicates that people willing to be screened are aware of the benefits of early diagnosis, and/or have a friend or relative with Alzheimer’s disease.
Older adults see benefits to screenings
"Our study provides insight into what patient's think about dementia screening," Dr. Fowler said.
In addition to informing policymakers and researchers, we should make community physicians and others outside the academic community more aware of both the benefits of informing older adults about screening options for dementia and the willingness of this group to undergo screening either in person or by telephone.
“Our work on this paper falls on a spectrum of a theme we’ve been investigating,” Fowler told nuviun in a phone interview.
In 2003, and again in 2012 or 2013, the US preventive services task force reviewed dementia screening in primary care, and found that there was insufficient evidence to support screenings. We wanted to find out what patients think about them.
Through her research into dementia screening, Fowler told nuviun, she found “a belief that there’s a benefit of knowing early, whether it’s to help [patients] talk to [their] doctors or families, or to initiate treatments earlier.” If the screening results are consistent with dementia, patients are referred to a primary care physician for full diagnostic testing.
A new case of dementia is diagnosed every four seconds
Worldwide, there are an estimated 47.5 million people living with dementia, according to the World Health Organization. This number is expected to increase to 75.6 million by 2030 and 135.5 million by 2050.
Early diagnosis of dementia can greatly improve quality of life, not just for the patient but for family members and caregivers as well.
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.