by Douglas Scharre, MD
As the population is getting older, more seniors are developing cognitive and memory problems that are affecting their abilities to think, function, and be independent. More families (spouse and children) are required to give up their time to assist. However, patients and families realize the gravity of the situation too late resulting in many dollars spent for medical care that could be avoided and much burden and stress of caring by families that could be lessened.
It doesn’t have to be this way! Research has shown that early identification of memory and thinking issues can alter the clinical course of patients and reduce the burdens on families. Those individuals with definite but very mild memory problems decline slower if started on current available medications to help memory than those started even 6 months later. Experimental anti-amyloid disease modifying approaches now show the same pattern. Patients that function better need less assistance, remain more independent, and reduce the stress on caregivers.
As patients get older they tend to develop more chronic health conditions that require therapy and monitoring to prevent complications. Still independent patients with mild impairments in thinking are not as careful in keeping up with their other medical conditions and become less compliant, forgetting medications more often, miss timing of medications, not paying attention to medical diets and taking less care of themselves. Many research studies, like ones looking at diabetics with memory loss, show that those individuals have more complications of their diabetes, spend more in health care dollars and are not as vigilant in disability prevention techniques.
The new health care law now allows Medicare participants to have an Annual Wellness Visit with their primary care physician (PCP). The purpose of this visit is to promote healthy habits and disease identification through screening and prevention practices. Medicare promotes cognitive screening at these visits. Physicians can screen anyway they like, but they should screen. Clinician administered tests like MMSE, mini-cog and others or self-administered assessment tools like SAGE (sagetest.osu.edu) are being used more frequently but not often enough.
When individuals are identified early through screening, the PCP can attack the disease at an early stage by beginning appropriate treatments, suggesting more supervision to prevent complications of their other chronic disorders, and sending families to their local Alzheimer’s Association chapter to help support caregivers and reduce their stress. Do not delay seeking help for those who forget. The time to act is now.
Douglas Scharre, MD, is the Director, Division of Cognitive Neurology and a
Associate Professor of Neurology at The Ohio State University Medical Center and Medical Director, Neurobehavior and Memory Disorders Clinics