Published on: February 13, 2012
by Barbara Peters Smith for Herald Tribune
Older patients are not routinely screened for signs of cognitive impairment by their primary care doctors, and the findings of a new study suggests that they should be.
Current guidelines recommend testing brain function only when a patient voices a specific complaint, such as memory lapses. But when veterans 70 and older at the Minneapolis VA Health Care System received brief tests and offers of further evaluation when indicated, new diagnoses of cognitive impairment among them jumped to more than double the previous rate. Mild cognitive impairment — small failures in reasoning and memory — is often but not always a forerunner to dementia.
The study appears in the February issue of the Journal of the American Geriatrics Society. A team led by J. Riley McCarten of the University of Minnesota assessed the effect of screening in patients who were seen in VA primary care clinics and had no indiction of memory loss.
Of 8,342 Veterans offered screening, 97 percent accepted. About 26 percent of those screened failed the first test and 28 percent of them agreed to further evaluation. In that group of 580 veterans, 93 percent were documented to have cognitive impairment, including 75 percent with dementia.
And then there were those who passed the first test but decided to undergo more extensive evaluation. Of those 118 patients, 87 percent were found to have cognitive impairment, including 70 percent with dementia.This suggests that many people suffering from dementia need only be offered an opportunity to seek help.
“Our study demonstrates that proactive strategies such as routine screening are well-accepted and effective in diagnosing cognitive impairment, and that primary care providers value the diagnostic and management services involved,” McCarten said in a statement. “This project has implications for strategies that seek to improve care and contain costs in dementia.”
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