Many Seniors Aren't Getting Dementia Tests

By Jane Farrell

Millions of seniors with signs of cognitive impairment haven’t seen a doctor about them, according to a new study from the University of Michigan.

The researchers said the findings indicate that up to 1.8 million seniors over 70 aren’t evaluated for cognitive symptoms. A failure to do that, the investigators said, could mean that some patients won’t be treated for symptoms that could be improved or that their care will be delayed.

The study was published in Neurology, the medical journal of the American Academy of Neurology. It included people with a variety of symptoms ranging from mild cognitive impairment through severe dementia.

“Early evaluation and identification of people with dementia may help them receive care earlier,” says study author Vikas Kotagal, M.D., M.S., who sees patients at the University of Michigan Health System and is an assistant professor in the U-M Medical School’s Department of Neurology. “It can help families make plans for care, help with day-to-day tasks including observed medication administration, and watch for future problems that can occur. In some instances, these interventions could substantially improve the person’s quality of life.”

The statistics were gathered before the implementation in 2011 of Medicare’s free annual wellness visit. Under the Affordable Care Act, these visits are required to include a cognitive evaluation.

In their investigation, researchers looked at a nationally representative, community-based study called the Health and Retirement Study, based at the University of Michigan. A total of 856 people aged 70 or older were evaluated for dementia. Among that group, 297 people met the criteria for dementia. But only 45 percent of them had seen their doctor about the problems.

Additionally, 5 percent of subjects with memory and thinking problems that did not meet the criteria for dementia had been tested by a doctor, and 1 percent of those with normal memory and thinking skills had undergone testing.

Researchers estimated nationwide statistics based on those findings.

The study also found that married people were more than twice as likely as unmarried people to undergo testing – perhaps because people feel comfortable discussing their concerns with a spouse.  “Another possibility,” Kotagal says, “could be that unmarried elderly people may be more reluctant to share their concerns with their doctor if they are worried about the impact it could have on their independence.”