Unnoticed memory issues pose threat to millions of elderly Americans – concerns for aging population in the US

Visual Representation for memory loss | Credits: Stock Adobe Photo
Visual Representation for memory loss | Credits: Stock Adobe Photo

United States: A recent study has revealed that the older population in the United States is largely unaware of memory and thinking impairments, presenting a diagnostic challenge for doctors who are unable to identify these impairments among millions of individuals.

The research, based on the analysis of Medicare data covering approximately 40 million older Americans, indicates that only a small percentage of anticipated cases of Mild Cognitive Impairment (MCI) are officially diagnosed by doctors. More than 7 million cases went unnoticed or undiagnosed.

Mild Cognitive Impairment

Mild cognitive impairment refers to experiencing difficulties with memory, thinking, and understanding, surpassing the typical forgetful moments associated with aging. It doesn’t render individuals completely incapable but signifies more than minor lapses in memory.

Manifestations of MCI may include forgetting appointments, frequently misplacing belongings, struggling to comprehend narratives in books or movies, or finding it challenging to navigate familiar places.

The Alzheimer’s Association discloses that Alzheimer’s is detected in approximately ten adults with MCI each year.

Dr Saket Saxena, a specialist in geriatric care at the Cleveland Clinic who was not involved in the study, notes that most often, MCI is caused by factors that can be addressed. These include medication side effects, insufficient thyroid hormone, depression, untreated sleep problems, poorly managed health issues like diabetes, mobility challenges, and social isolation.

Visual Representation for Mild Cognitive Impairment | Credits: Google Images

Soeren Mattke, the director of the Brain Health Observatory at the University of Southern California, emphasizes, “It is not a foregone conclusion that you’re going to develop dementia,” and highlights the treatable or reversible causes of MCI as a compelling reason for primary care doctors to actively seek it. However, the study suggests this seldom happens.

Research spanning 2017 to 2019 using Medicare data reveals that American primary care doctors only recognized about 8 percent of the memory problems they should have observed in older patients. Despite expectations of around 8 million cases of memory problems based on patient details, approximately 7.4 million cases went unnoticed due to doctors not identifying them.

Mattke expresses surprise at the extent of this oversight, stating, “We expected it to be bad, but not that bad.” The findings were published in the Journal of Prevention of Alzheimer’s Disease on October 24.

Mattke clarifies that the absence of an official diagnosis in Medicare files doesn’t necessarily mean doctors aren’t discussing memory problems with their patients. Rebecca Edelmayer, senior director of scientific engagement for the Alzheimer’s Association, acknowledges the challenges faced by primary care doctors in dealing with cognitive health issues during short appointments with older patients.

A 2022 survey by the association found that 77 percent of primary care doctors find it challenging to identify MCI, and patients often resist acknowledging the problem.

In light of these challenges, Edelmayer stresses the need for more support for primary care doctors, including information, tools, and resources for early and accurate diagnosis.

It’s noteworthy that the study received partial funding from drugmaker Genentech, and researcher Soeren Mattke received consulting fees from various drug companies, including Biogen, the maker of new Alzheimer drugs Leqembi and Aduhelm.

The recent availability of these medications adds complexity to MCI detection. Edelmayer points out that early detection is crucial for the drugs‘ effectiveness, especially as they are designed for individuals in the early stages of Alzheimer’s.

While screening tests are essential, determining the root cause of MCI requires more than that; biological evidence of Alzheimer’s is also crucial. The new drugs often involve tests like brain scans or spinal taps to identify abnormal protein build-ups in the brain.

All experts agree that due to the diverse reasons for MCI, it’s essential for older adults to engage in conversations with their doctors about their unique situations.

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