Many older people have dementia but they don’t know it

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In a new study from the University of Michigan, researchers found only 1 in 10 older adults in a large national survey who were found to have cognitive impairment consistent with dementia reported a formal medical diagnosis of the condition.

They used data from the Health and Retirement Study to develop a nationally representative sample of roughly 6 million Americans age 65 or older.

The team found that 91% of people with cognitive impairment consistent with dementia told questioners they did not have a formal medical diagnosis of Alzheimer’s disease or dementia.

When proxy reporters (generally, family members) responded, the prevalence dropped from 91% to around 75%, which is still very significant.

While many people may have been diagnosed and remain unaware or forgot about their diagnosis, what’s concerning is that cognitive assessment, specifically dementia screening, isn’t routine during annual well visits for older adults.

COVID-19 gives these numbers heightened significance because people with dementia have a higher risk for hospitalization and death following an infection.

COVID-19 also causes long-standing neurological effects in some people, perhaps increasing the risk for future dementia-related diagnoses.

The team suggests that the migration to telemedicine during the COVID-19 pandemic further underscores the importance of cognitive assessments.

They recommend that health care providers screen for low cognitive functioning during routine health assessments when possible. A telemedicine option may reduce clinic time and expand reach.

The prevalence of not having reported a dementia-related diagnosis, despite being identified as living with a cognitive impairment consistent with dementia, differed by gender, education, and race.

The Medicare visit is supposed to include a cognitive screening, but it can be difficult to ascertain a cognitive concern in a 20-minute annual visit. Adding a specific cognitive assessment can also take up visit time.

The team encourages open communication and reminds families that they can still share information with the loved one’s provider directly or through a nurse or medical assistant.

If you care about dementia, please read studies about statin and blood pressure drug combos may help reduce dementia risk and findings of this common brain disease could lead to dementia.

For more information about dementia and your health, please see recent studies about these personality traits may protect you from dementia and results showing that hearing loss linked to Alzheimer’s disease, dementia.

The study is published in the Journal of Alzheimer’s Disease. One author of the study is Sheria Robinson-Lane.

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