CHARLOTTE – Despite a strong belief among seniors and primary care physicians that brief cognitive assessments are important, only half of seniors are being assessed for thinking and memory issues, according to findings from the Alzheimer’s Association 2019 Alzheimer’s Disease Facts and Figures. Much fewer receive routine assessments.
The report examines awareness, attitudes and utilization of brief cognitive assessments among seniors age 65 and older.
A brief cognitive assessment is a short evaluation for cognitive impairment performed by a health-care provider that can take several forms, including asking a patient about cognitive concerns, observing a patient’s interactions, seeking input from family and friends or using short verbal or written tests.
An evaluation of cognitive function is required with a Medicare Annual Wellness Visit, but findings from the report show only one in three seniors are aware these visits should include this assessment.
The report also found, however, that among both seniors and primary care physicians, there is widespread understanding of the benefits of early detection of cognitive decline and the importance of brief.
In fact, 82 percent of seniors believe it is important to have their thinking and memory checked, and nearly all primary care physicians (94 percent) consider it important to assess all patients age 65 and older for cognitive impairment.
“Given the enormous burden Alzheimer’s has on individuals living with the disease, their families and the country as a whole – it must remain a public health priority for North Carolina and our nation,” said Katherine Lambert, CEO of the Alzheimer’s Association – Western Carolina Chapter. “This report reveals there is still a gap in seniors getting routine cognitive assessments that are critical for early detection of Alzheimer’s and other dementias. We encourage seniors and physicians to be more proactive in discussing cognitive health and doing a cognitive assessment during the Annual Wellness Visit and other routine exams.”
The report found that just one in seven seniors (16 percent) say they receive regular cognitive assessments for memory or thinking issues during routine health checkups.
The Facts and Figures report also reveals a disconnect between seniors and primary care physicians regarding who they believe is responsible for initiating these assessments.
The survey found that while half of all seniors (51 percent) are aware of changes in their cognitive abilities, including changes in their ability to think, understand or remember, only four in 10 (40 percent) have ever discussed these concerns with a health-care provider, and fewer than one in seven seniors (15 percent) report having ever brought up cognitive concerns on their own.
Instead, most seniors (93 percent) say they trust their doctor to recommend testing for thinking or memory problems if needed. Yet fewer than half of primary care physicians (47 percent) say it is their standard protocol to assess all patients age 65 and older for cognitive impairment. Only one in four seniors (26 percent) report having a physician ever ask them if they have any concerns about their cognitive function without seniors bringing it up first.
Nearly all physicians said the decision to assess patients for cognitive impairment is driven, in part, by reports of symptoms or requests from patients, family members and caregivers. Physicians who choose not to assess cognition cite lack of symptoms or complaints from a patient (68 percent), lack of time during a patient visit (58 percent) and patient resistance (57 percent) as primary factors.
Most physicians say they welcome more information about assessments, including which tools to use (96 percent), guidance on next steps when cognitive problems are indicated (94 percent) and steps for implementing assessments efficiently into practice (91 percent).
“The Alzheimer’s Association – Western Carolina Chapter is committed to help educate physicians on best practices for conducting brief cognitive assessments and to encourage seniors to proactively discuss thinking and memory concerns with their doctor,” Lambert said. “This proactive approach with increased communication plays a critical role in early detection to ensure that affected individuals and their families have the best opportunity to plan for the future.”