Study: Majority of Seniors With Dementia Lack Diagnosis

More than half of elderly Americans with dementia are not evaluated for cognitive symptoms by a medical provider, a new study finds.

As many as 1.8 million Americans over the age of 70 with dementia are not medically evaluated, found University of Michigan researchers in a study published in the online publication “Neurology.”

Two hundred ninety-seven of 845 subjects in the Aging, Demographics, and Memory Study (ADAMS), a nationally representative community-based cohort study, met criteria for dementia after a detailed in-person study examination; yet, of those who met the criteria for dementia 55.2% reported no history of a clinical cognitive evaluation by a physician. 

And early evaluation is important, as it can help families make plans for care, help with day-to-day tasks including observed medication administration, and watch for future problems that can occur, says study author Dr. Vikas Kotagal, who sees patients at the University of Michigan Health System and is an assistant professor in the U-M Medical School’s Department of Neurology, in a statement.

“In some instances, these interventions could substantially improve the person’s quality of life,” Kotagal says.

Those who were married, and those with the worst levels of dementia symptoms, were more likely to have had their memory and thinking ability evaluated by a primary care doctor, neurologist or psychiatrist, study results show. The study included people with mild cognitive impairment through severe dementia, from all causes.

“It’s possible that spouses feel more comfortable than children raising concerns with their spouse or a health care provider,” Kotagal says about the significance of marital status on seeking care. “Another possibility could be that unmarried elderly people may be more reluctant to share their concerns with their doctor if they are worried about the impact it could have on their independence.”

Perceptions surrounding clinical cognitive exams, as well as other factors, may be playing a role in the lack of testing among older adults exhibiting signs of dementia.

Many patients and physicians may perceive that related testing doesn’t have enough value, Kotagal says. But, experts have shown that they can improve medical outcomes and help reduce societal costs, he says.

“For instance, knowing that a stroke or vascular issues in the brain caused dementia means patients can work to control risk factors like blood pressure that might otherwise cause it to keep worsening,” the University of Michigan says.

Access the study here.

Written by Cassandra Dowell

Cassandra Dowell