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   Most Seniors With Signs of Dementia Don't Get Tested   
      
   By JANICE WOOD Associate News Editor   
      
   Reviewed by John M. Grohol, Psy.D. on November 29, 2014      
      
   Most Seniors With Signs of Dementia Don't Get Tested   
      
      
   A new study finds that more than half of people over the age of 70 with signs   
   of dementia haven't seen a doctor about it.   
      
   Researchers from the University of Michigan say their findings suggest that as   
   many as 1.8 million Americans over the age of 70 with dementia have not been   
   evaluated by a physician.   
      
   "Early evaluation and identification of people with dementia may help them   
   receive care earlier," said 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 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 data in the study was collected before the start of Medicare's free annual   
   wellness exams for seniors, which began in 2011 under the Affordable Care Act,   
   the researchers noted. A cognitive evaluation is required as part of those   
   free exams.   
      
   The study was part of the larger Health and Retirement Study, based at the   
   university's Institute for Social Research.   
      
   From that study, 856 people age 70 and older were evaluated for dementia,   
   including a video interview and standard testing. The researcher also asked a   
   spouse, child, or friend of each participant if the participant had ever seen   
   a doctor for any    
   concerns about memory or thinking.   
      
   According to the researchers, 297 of the participants met the criteria for   
   dementia. Of those, 45 percent had seen a doctor about their memory problems   
   -- and the more severe their issues, the more likely they had had that   
   evaluation.   
      
   By comparison, five percent of those with memory and thinking problems that   
   did not meet the criteria for dementia had been tested by a doctor for those   
   issues, and one percent of those with normal memory and thinking skills had   
   undergone testing, the    
   study found.   
      
   The researchers also found that people who were married were more than twice   
   as likely to undergo cognitive evaluations as people who were not married.   
      
   "It's possible that spouses feel more comfortable than children raising   
   concerns with their spouse or a health care provider," said Kotagal. "Another   
   possibility 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."   
      
   Other demographic factors did not have an effect on whether people had   
   cognitive evaluations, including race, socioeconomic status, the number of   
   children, and whether children lived close to the parents, according to the   
   researchers.   
      
   "Our results show that the number and proximity of children is no substitute   
   for having a spouse as a caregiver when it comes to seeking medical care for   
   memory problems for a loved one," Kotagal said.   
      
   While the study doesn't answer the question of why people with signs of   
   dementia don't get tested, Kotagal suggests that many factors may be involved   
   -- some driven by the patient, some by physicians, and others by the nature of   
   the nation's health    
   system.   
      
   "Many patients and physicians may believe that clinical cognitive exams don't   
   have enough value," he said.   
      
   But experts have shown that they can improve medical outcomes and help reduce   
   societal costs. For instance, knowing that a stroke or vascular issues in the   
   brain caused dementia means patients will be more likely to control risk   
   factors like blood    
   pressure, Kotagal noted.   
      
   "The next steps in research on this topic are to find out why patients don't   
   get tested, and what parts of the diagnostic process are most valuable to   
   patients and caregivers," he concluded.   
      
   The study was published in Neurology, the medical journal of the American   
   Academy of Neurology.   
      
   Source: University of Michigan Health System   
      
       
   http://psychcentral.com/news/2014/11/29/majority-of-seniors-with   
   signs-of-dementia-dont-get-tested/77923.html   
      
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