There may be more older people with undiagnosed dementia than previously thought

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Only 1 in 10 older adults in a large national survey that found cognitive impairment consistent with dementia reported a formal medical diagnosis of the disease.

Using data from the Health and Retirement Study to develop a nationally representative sample of about 6 million Americans age 65 and older, researchers from the University of Michigan, North Dakota State University, and the University of ‘Ohio found that 91% of people with consistent with told questioners that they had no formal medical diagnosis of Alzheimer’s disease or dementia.

“(The discrepancy) was higher than I expected,” said Sheria Robinson-Lane, co-author of the study and assistant professor at the UM School of Nursing.

When representative journalists (usually family members) responded, the prevalence dropped from 91% to 75%, which is still very significant, he said. Although many people may have been diagnosed and are unaware or have forgotten their diagnosis, the concern is that cognitive assessment, specifically dementia screening, is not routine during annual well visits for dementia. older adults.

COVID-19 gives higher importance to these figures because people with dementia have a higher risk of hospitalization and death after an infection, Robinson-Lane said. COVID-19 also causes long-term neurological effects in some people, perhaps increasing the risk of future diagnoses related to dementia.

“Now more than ever, these routine tests and assessments are really critical,” he said. “I think it’s particularly important to have basic information available for providers of patients over the age of 65.”

Co-author Ryan McGrath, an assistant professor at North Dakota State University, suggested that migration to telemedicine during the COVID-19 pandemic further underscores the importance of cognitive assessments.

“We recommend that health care providers select low cognitive functioning during routine health assessments when possible,” he said. “A telemedicine option can reduce clinic time and expand scope.”

The prevalence of not having reported a dementia-related diagnosis, although identified as living with cognitive impairment consistent with dementia, was differentiated by gender, education, and race.

People who identified as non-Hispanic blacks had a higher estimated prevalence (93%) of no reported diagnosis, as did men (99.7%) compared to women (90.2%). was approximately 93.5%, compared with 91% in those with at least one .

“There is a big disparity in treatment related to dementia and between blacks , who are often diagnosed much later in the disease trajectory compared to other racial and ethnic groups, ”Robinson-Lane said.

Education is often a proxy , so that throughout life, richer individuals have more access to resources that affect both risk and disease progression, he said. And, evidence suggests that education may influence the performance of cognitive tests.

The visit to Medicare is supposed to include cognitive screening, but it can be difficult to determine a cognitive concern on an annual 20-minute visit, he said. Adding a specific cognitive assessment may also require visiting time.

Robinson-Lane often feels worried those who do not know the next steps or the family member who cares about them want to maintain independence and privacy and doctors cannot share information without the patient’s consent.

It encourages open communication and reminds families that they can still share information with the loved one’s provider directly or through a nurse or medical assistant.


How accurate are virtual assessments of cognitive function?


More information:
Ryan McGrath et al, Self-Declared Dementia Diagnosis, Underestimates the Prevalence of Older Americans Living with Possible Dementia, Journal of Alzheimer’s disease (2021). DOI: 10.3233 / JAD-201212

Citation: There may be more older people with undiagnosed dementia than previously thought (2021, June 23), retrieved June 24, 2021 at https://medicalxpress.com/news/2021-06-seniors-undiagnosed -dementia-previous-thought.html

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