Should all older adults undergo regular memory screening as part of their primary care regimen?
Probably not, says a government-appointed panel, after they failed to find enough proof in favor of—or against—conducting regular mental assessments on most elderly individuals.
“There is a critical gap in the evidence,” says Douglas Owens, M.D., M.S., a member of the task force. “More research is needed so we can better understand the benefits and risks of screening and understand the impact early detection can have on the lives of patients and their families.”
Every Medicare beneficiary is legally eligible to obtain no-cost screening for cognitive impairment during the annual “wellness” visit—a mandate that’s unlikely to change as a result of the panel’s ruling. But most aging adults don’t actively seek out this benefit unless they (or their family members) notice problems with memory or mental processing.
A physician who suspects an elder has cognitive impairment typically administers a series of written and oral exams to both the senior and their family member(s). This enables the primary care doctor to get a good sense for the aging adult’s overall health. Depending on the doctor’s determination, they may decide to refer the elder to a specialist, such as a neurologist or neuropsychiatrist, for further evaluation.
Experts agree that the earlier a source of cognitive impairment can be identified, the more impactful any intervention—medicinal or otherwise—will be; yet nearly 50 percent of people with dementia remain undiagnosed, according to the Alzheimer’s Association.
In some cases, dementia is a reversible condition brought on by one of several potential culprits, including: drug interactions, a malfunctioning thyroid, poor nutrition, depression, etc. Once the root cause has been treated, an individual’s cognitive issues are often resolved.
Other forms of dementia, such as Alzheimer’s and Lewy Body, don’t yet have truly effective treatments.
Especially in these instances, the benefits of early detection must be weighed against the emotional, social and financial costs that can result from a false positive diagnosis. A misdiagnosis of Alzheimer’s disease can cost a family upwards of $14,000 per year in additional healthcare costs and the stigma of Alzheimer’s places a heavy burden on those living with the disease.
Yet, even the experts can’t say for certain whether early detection of Alzheimer’s and other incurable types of dementia would truly be helpful for elders and their families.
For now, the task force recommends that people who are experiencing cognitive issues seek further evaluation from their doctor, while those whose minds still seem sharp should hold off. Caregivers and other family members can also help by keeping their eyes out for warning signs that an elderly family member needs help.
What do you think? Should all adults beyond a certain age receive regular cognitive exams, or should we wait until a cure or therapy for Alzheimer’s and other forms of dementia is discovered?