Alzheimer’s disease is a growing issue among Americans, but just 16% of seniors reported being regularly screened for cognitive issues, according to the Alzheimer’s Association’s new 2019 report.
“There’s under-utilization of cognitive assessment in the clinical setting, and a disconnect between patient and provider over who should be initiating it,” says Joanne Pike, chief program officer at the Alzheimer’s Association. “[In] an ideal world, 100% of physicians initiate it, and 100% of seniors bring it up.”
The new report finds that while the majority of doctors and seniors think cognitive screening is important, issues on both sides sometimes prevent assessments from happening: doctors are tight for time at appointments, patients often don’t have symptoms or complaints and seniors sometimes do not know that they should be tested—or decide not to complete it. Less than 30% of seniors said they’d ever had a cognitive assessment, and only about a third knew that this type of screening must be available through Medicare-provided annual wellness visits.
If more elderly adults knew about this benefit, Pike says, it could increase screening rates and point seniors toward therapies for treatable contributors to cognitive decline — such as depression and sleep apnea — or help them prepare for the toll of currently untreatable conditions, such as Alzheimer’s.
“If you do go on to be diagnosed with dementia or Alzheimer’s, there’s medical, social and familial benefits to knowing that diagnosis,” Pike says. “You can do some financial planning and legal planning. You can spend time with family and friends, or do the things that bring you joy.”
If more people were diagnosed earlier, more patients could also participate in clinical trials, says Keith Fargo, director of scientific programs and outreach at the Alzheimer’s Association. And though it’s not a short-term solution, making clinical trials more robust is the best way to eventually cut into ever-growing Alzheimer’s incidence rates, Fargo says. Nearly 6 million Americans are currently living with Alzheimer’s dementia, and that number is projected to exceed 7 million by 2025, according to the new report.
“If you don’t know you’ve got this disease, you’re not participating in a clinical trial,” Fargo says. Without the participants needed for large-scale clinical trials, doctors can’t develop drugs that could treat Alzheimer’s, Fargo says.
Finding effective therapies is a priority. Alzheimer’s and dementia currently cost the nation roughly $290 billion each year, not including the steep financial and emotional costs borne by the 16 million Americans who serve as unpaid Alzheimer’s caregivers.
And as America’s population ages, more people are dying from Alzheimer’s than they used to, Fargo says. It’s now the sixth leading cause of death in the U.S., according to federal data. Between 2000 and 2017, the disease’s death rate increased by 31% among people ages 65 to 74, by 57% among people ages 75 to 84 and by 86% among people older than 85, according to the new report.
“More of us are dying from Alzheimer’s instead of heart disease and stroke, as we get better at treating heart disease and stroke,” Fargo says. “It’s a mix of living longer and doctors being better at identifying it and listing it on death certificates.”
Researchers have not found any conclusive way to prevent or reverse Alzheimer’s, but some recent studies have produced promising findings in the field of brain health. One study, published in December, found that diet and exercise may reverse some age-related brain changes, while one published in February found that doing physical and mental exercise early in life can prevent some of those changes in the first place.