Should Dementia Screenings Be Part of Routine Care?
Last updated: Feb 14, 2012
Here's a question for everyone who worries about a loved one's memory -- or every dementia caregiver who has ever wondered if his or her own memory is slipping: Would it be helpful if cognitive checks were done routinely, as part of a primary-care exam?
A new study in the Journal of the American Geriatrics Society reports that screenings with a two-minute "mini-cog" cognitive screening test increased the number of dementia cases detected by two- to threefold -- uncovering many cases that would otherwise have gone unnoticed by doctors.
Nearly 11 percent of the 8,000 veterans screened by the Minnesota Veterans Affairs Medical Center were found to have some form of cognitive impairment, compared to 4 percent in clinics that didn't use this test. All the vets were over 70 and had no known history of memory problems. More than 90 percent of the discovered impairments were confirmed in follow-up testing. (The mini-cog has many varieties; all are fast and easy -- this one involved remembering words and drawing a clock face.)
"I think there's increasing data in the last few years that unrecognized cognitive impairment leads to worse health outcomes," study leader Riley McCarten, a neurologist at the Minneapolis V.A., told The Minneapolis Star Tribune.
Detection of problems enables doctors to pinpoint and possibly treat possible non-Alzheimer's causes of dementia symptoms. Also, early detection allows families to deal with issues that memory loss may be affecting, like medication compliance, family finances, and to plan for the future.
The real fly in the ointment of early screenings, in the absence of a cure for Alzheimer's, is that it's often beyond the expertise and scope of a limited office visit for physicians to provide meaningful assistance re driving, finances, and social isolation, notes geriatrician Leslie Kernisan of the Over 60 Health Center in Berkeley, California. For that kind of help and information, families of those whose dementia is detected early have to look elsewhere. But at least having knowledge of what they're facing is better than being left in the dark.