Alzheimer’s disease is one of the most prevalent and devastating aging diseases, but according to a new report by the Alzheimer’s Association, a significant number of older adults with memory problems are not discussing these issues with their doctors.
The study, which focused on whether physicians and patients are discussing the early warning signs of Alzheimer’s, found that older adults frequently avoided the topic with their doctors.
Fear of misdiagnosis, unnecessary treatments, or the devastating confirmation of dementia kept many from sharing their struggles.
Dr. Nicole Purcell, senior director of clinical practice for the Alzheimer’s Association, noted this avoidance is worrying because understanding and diagnosing memory and cognitive problems is crucial.
In some cases, these problems may not be dementia, but rather treatable medical conditions like sleep apnea or a thyroid disorder.
Moreover, new treatments are becoming available that can slow the progression of Alzheimer’s.
Two FDA-approved drugs, Aduhelm and Leqembi, target the disease’s underlying biology by helping clear the brain of abnormal protein clumps known as amyloid “plaques” – a hallmark of Alzheimer’s.
However, these medications are currently only covered by Medicare if the patient is enrolled in a clinical trial, presenting a significant financial barrier.
Early diagnosis of Alzheimer’s is still vital for numerous reasons, according to the experts.
Medicare coverage decisions could change in the future, and patients need help with future planning, managing coexisting health conditions, medication, and daily challenges.
The report, released on March 15, was part of the Alzheimer’s Association’s annual Facts and Figures update, examining the impact of Alzheimer’s on Americans and the healthcare system.
It drew on focus group discussions, including people experiencing “subjective cognitive decline” – a self-perceived increase in memory or cognitive problems.
Unfortunately, these individuals were often reluctant to consult their doctors, instead choosing to discuss their symptoms with family or friends.
Moreover, racial and ethnic minority groups, including Black, Hispanic, Asian, and Native Americans, expressed a particular distrust of being prescribed medications and preferred a “holistic” approach to their cognitive issues.
Racism in the medical field was also raised as a concern.
Physicians are also guilty of avoiding these discussions, often relying on family members to voice any worries. Dr. Purcell pointed out that primary care providers, dealing with numerous issues in their aging patients, often overlook proactive brain health discussions.
Furthermore, specialists such as neurologists and geriatricians are in short supply in many areas, leaving primary care doctors unsure where to refer patients.
Diagnosing mild cognitive impairment is challenging, but there are tests, including brain scans and tests of the cerebral spinal fluid that detect amyloid levels, which can provide objective evidence of early Alzheimer’s.
However, these tests are often not covered by insurance.
Despite these barriers, Dr. Martin Sadowski, a professor of neurology and psychiatry at NYU Grossman School of Medicine, is a strong advocate for early diagnosis.
He highlighted that diagnosing treatable conditions like sleep apnea can significantly improve quality of life. The situation is continually evolving, with numerous ongoing clinical trials testing new treatments for Alzheimer’s.
The amyloid-clearing drugs, while not a panacea for Alzheimer’s, do show promise, and other Alzheimer’s treatments are also under trial, targeting different underlying processes of the disease.
Research into Alzheimer’s disease is starting to bear fruit, 40 years after it began. However, to benefit from these advances, early, accurate diagnosis is critically important.
If you care about Alzheimer’s disease, please read studies about daytime napping strongly linked to Alzheimer’s disease, and how to treat mild to moderate Alzheimer’s disease.
For more information about brain health, please see recent studies about how Alzheimer’s disease is treated, and results showing alternative drug strategies against Alzheimer’s disease.
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