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Seniors Largely Ignore Cognitive Checkups

Seniors Largely Ignore Cognitive Checkups
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March 7, 2019
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Just one out of seven of seniors take part in assessments for cognitive problems, according to a new report from the Alzheimer’s Association. But much higher numbers get regular screenings for ailments like heart disease, diabetes and cancer.


The disconnect means that millions of seniors with early cognitive problems aren’t getting medical attention early, when it can be most helpful, said the report, issued on Tuesday. Problems with cognition can have many causes, said Katie Croskrey, executive director of the association’s chapter for San Diego and Imperial counties. These include dehydration, stress, side effects of medication and poor blood circulation to the
brain, Alzheimer’s, or a mixture of causes. These issues can be detected early on with a variety of cognitive tests.

One of the most popular cognitive screens is the Montreal Cognitive Assessment. It’s usually given in person and takes about 15 minutes, said Ana Seda, the chapter’s director of programs. These include such tasks as drawing the hands of an analog clock, counting backward in a sequence, and repeating sentences exactly as given.

If the assessment reveals a possible problem, a doctor will rst check for issues not related to dementia,
Croskrey said. If those causes are ruled out, at that point the patient would be sent to a neurologist for more
sophisticated tests, such as a CT scan.

While there are several causes of dementia, Alzheimer’s accounts for most cases. Both the number of
Alzheimer’s patients and number of deaths from the disease are increasing.

In 2017, 16,238 Californians died of Alzheimer’s, a 268 percent increase over the number in 2000, the report
stated. Nationwide, more than 5 million Americans now have Alzheimer’s, and by 2050 that number is projected
to reach 14 million.

By contrast, deaths from heart disease and cancer from 2000 to 2017 have actually gone down, Croskrey said.
When it comes to physical maladies, 91 percent of seniors get their blood pressure measured; 66 get tested for
diabetes; and 61 get cancer screenings. In addition, 83 percent get their cholesterol measured; 80 percent get
vaccinations; and 73 percent get hearing or vision check.

Just 16 percent of seniors get thinking and memory assessments, and even fewer get them regularly, according
to the report. Croskrey said one explanation is that people simply aren’t discussing their worries about thinking or memory loss with their physicians.

A healthy neuron boasts multiple connections via fibrous axons to other nerve cells. Alzheimer’s disease causes affected neurons to shrink, lose connections and function, and eventually die. The blue traces an electrical signal as it moves through synapses to the yellow neuron. (Michael A. Colicos / UCSD)

“The doctor probably won't do a memory test unless you share some concerns about your memory,” she said. That means people need to bring up the subject.
It’s normal to become more forgetful with aging, Croskrey said. Simply misplacing keysor other objects isn’t by itself a sign of dementia.

“If you find your keys in therefrigerator or you find them in other odd places where you cannot retrace your steps, then that's something you want to raise with your doctor,” Croskrey said.

Fear is a major reason people don’t ask for cognitive screening, said Dr. Howard Feldman, director of the Alzheimer’s Disease Cooperative Study at UC San Diego.

“It is really a dreaded event in a person's life,” Feldman said. “Physical ailments, bad as they are, leave you with
mental intactness.”

In the worst case, dementia will take away a person’s “functional autonomy,” he said. Overriding all is a stigma about having dementia. Several factors make taking a cognitive test a wise idea for seniors, he said. One is that the patient may not have dementia at all, freeing that person from needless worry.

For those in the early stages of dementia, they have time to make important decisions, such as who will have
power of attorney and look after their assets. Waiting puts people at risk of being defrauded. Another is that certain health and lifestyle changes may reduce dementia’s toll, Feldman said. While the evidence for benet isn’t proven, at the very least these changes won’t cause harm. Early stage patients whose cognitive impairment is mild may also be good candidates for taking experimental drugs that just might slow or stop the course of the disease.
And in the later stages, voluntarily giving up autonomy, such as ceasing to drive, could save someone else’s life, he said.

Those with questions about Alzheimer’s or other forms of cognitive impairment can get answers around the
clock by calling the Alzheimer’s Association helpline at 1-800-272-3900. The association is online at www.alz.org.

Alzheimer's Association

The Alzheimer's Association leads the way to end Alzheimer's and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer's and all other dementia.™ For more information, visit www.alz.org or call the 24/7 Helpline at 800.272.3900.

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