In a major nationwide study, just one in ten older individuals with cognitive impairment compatible with dementia had a formal medical diagnosis of the illness.
Many Elderly Americans Have Undiagnosed Dementia
Researchers from the University of Michigan, North Dakota State University, and Ohio University discovered that 91 percent of people with cognitive impairment consistent with dementia told questioners they did not have a formal medical diagnosis of Alzheimer’s disease.
The sample consisted of 6,036,224 Americans aged at least 65 years old who were recognized as having a CICD without a history of stroke, cancer, neurological disorders, or brain injury and who took part in at least one wave of the 2010-2016 Health and Retirement Study. The Phone evaluation of Cognitive Status, as modified, measured cognitive functioning.
Those who had a score of 6 or less were regarded to have a CICD. The diagnosis of dementia in healthcare providers was self-reported. Age, gender, educational attainment, race, and ethnicity were all self-reported.
The disparity was more than expected, according to Sheria Robinson-Lane, research co-author and assistant professor at the University of Michigan School of Nursing.
When family members answered as proxy reporters, the prevalence fell from 91 percent to about 75 percent, which is still extremely substantial, she added. While many people have been diagnosed but are ignorant or have forgotten about their diagnosis, it is alarming that cognitive evaluation, especially dementia screening, is not common during yearly well visits for older persons.
COVID-19 heightens the relevance of these figures since individuals with dementia are more likely to be hospitalized and die as a result of an infection, according to Robinson-Lane.
COVID-19 also has long-term neurological consequences in some persons, perhaps raising the likelihood of future dementia diagnosis.
These periodic tests and evaluations are more important than ever, she says. She believes it is especially critical for providers of patients over the age of 65 to have some baseline information accessible.
The shift to telemedicine during the COVID-19 epidemic, according to co-author Ryan McGrath, an assistant professor at North Dakota State University, emphasizes the necessity of cognitive evaluations.
When feasible, they recommend that health care professionals test for impaired cognitive functioning during routine health examinations, he added. Telemedicine may minimize clinic time while increasing reach.
The incidence of not having reported a dementia-related diagnosis while being diagnosed with a cognitive impairment compatible with dementia varied by gender, education, and race.
Non-Hispanic Black people had a greater projected prevalence of no reported diagnosis (93 percent), as did males (99.7 percent) compared to females (90.2 percent). Non-high school graduates were projected to have a 93.5 percent prevalence of no reported diagnosis, compared to 91 percent for individuals with at least a high school diploma.
According to Robinson-Lane, there is a huge difference in dementia-related treatment and diagnosis among Black older individuals, who are frequently detected considerably later in the disease trajectory than other racial and ethnic groups.
Education is frequently used as a proxy for socioeconomic position, so wealthier people have more access to resources that impact both risk and illness progression throughout their lives, she explained. Furthermore, research shows that schooling may have an impact on cognitive testing results.
The Medicare appointment is meant to include a cognitive exam, but she claims it can be difficult to detect a cognitive issue in a 20-minute yearly visit. Including a specialized cognitive evaluation might further lengthen the appointment.
Robinson-Lane frequently hears from anxious family members, who don’t know what to do next, or the family member in question wants to retain independence and privacy, and physicians can’t disclose information without the patient’s agreement.
She promotes open communication and reminds families that they may still share information with their loved one’s physician, either directly or through a nurse or medical assistant.