Medical Professionals Online

Experts Call For Widespread Use Of Memory Screenings And Emphasize Value Of Early Detection Of Dementia

May 13, 2017

Top experts from the Alzheimer's Foundation of America (AFA) called for more widespread utilization of memory screenings, especially in light of research indicating that cases of mild and moderate dementia are not recognized often enough and that early diagnosis can lead to appropriate treatment and other positive interventions.

Eric J. Hall, AFA's chief executive officer, and J. Wesson Ashford, M.D., Ph.D., senior research scientist at the Stanford/VA Aging Clinical Research Center, Palo Alto, CA and chairman of AFA's Memory Screening Advisory Board, made their remarks at a Congressional policy briefing in Washington, DC.

The issue was discussed as part of AFA's efforts during National Alzheimer's Disease Awareness Month in November to raise awareness of the importance of early detection. Other initiatives include AFA's annual National Memory Screening Day, which this year takes place on November 13 and involves a record number of screening sites from coast to coast.

"Time is of the essence in terms of making screenings more of the norm, especially as our population ages and the incidence of Alzheimer's disease escalates," Hall said. "We can't sit by any longer and watch waves of Americans being deprived of the care and support that can better their quality of life and that of their families."

The incidence of Alzheimer's disease, which leads to loss of memory and other cognitive functions, is expected to triple to 16 million in the United States by mid-century. Age is the greatest risk factor; other risk factors are family history, genetic makeup and co-existing medical conditions.

"The United States medical system is not properly equipped to deal with this problem and this needs to be remedied," Ashford said.

His recommendation: "Broad implementation of memory screening is highly cost-worthy now. Screening will lead to more diagnoses, which will advance the understanding of Alzheimer's disease and foster the development of better treatments."

According to Ashford, "Memory screening is one of the best tools to detect Alzheimer's disease or another problem that is causing memory loss. Impaired memory can be an indicator of many other conditions as well. The key is to find the root of the problem."

He also presented findings from two articles he co-authored entitled "Should Older Adults be Screened for Dementia?" that appeared in Alzheimer's & Dementia, The Journal of the Alzheimer's Association. In one of the articles, the authors conclude, "Dementia screening in clinical settings is clearly appropriate for those whose risk is above a certain threshold, for example, persons older than the age of 75 years."

"Now is the time to prepare for the future by developing dementia screening systems and memory testing programs that will be able to detect patients with early phases of dementia," the authors said.

Ashford noted that he and his co-authors in an earlier article found that routine screening should be supported because physicians miss at least half of the cases of mild and moderate dementia, only recognizing it when the brain disorder is at least moderately advanced.

According to the article, "Only the implementation of screening practices can rectify this failure of current diagnostic practices."

Reinforcing this, Hall pointed to newly-released results of an AFA survey of participants in its 2006 National Memory Screening Day. The survey found that while 73 percent of respondents had memory concerns and more than 80 percent had visited their primary care physician within the last six months, fewer than 10 percent of those with concerns had discussed the issue with the physician.

"These discussions must become more commonplace. We need to better educate healthcare professionals about recognizing symptoms, and we must stress to the public that fear and denial can hurt them in the long run," Hall said.

Hall and Ashford noted that early diagnosis has considerable potential benefits, including treatments and lifestyle choices, such as proper nutrition and mental stimulation, which can help delay progression of symptoms. In addition, it offers individuals the opportunity to do advance planning, address driving and other safety concerns, and participate in support groups and other programs while their intellectual abilities are more intact.

Also at the briefing today, the experts challenged Americans to consider their brain health, especially as they age.

"We should be forward thinking to see how to optimize our memory, and keep track of it and try to improve it, both as an early indicator of disease and to improve our success and enjoyment in the world," Ashford emphasized.

AFA has spearheaded advocacy efforts for the need for early detection, including the introduction of its annual National Memory Screening Day; strongly encouraging the Centers for Medicare & Medicaid Services to include language that now makes a review of a person's ability to perform activities of daily living--an evaluator of Alzheimer's disease--as a part of the "Welcome to Medicare" physical exam; and initiating successful resolutions in New York and California this year that declare November 13 as Memory Screening Day in each state.

In addition, AFA established its Memory Screening Advisory Board last year, bringing together the nation's leading experts to focus on this issue, as well as explore the most effective screening tools.

On AFA's 5th annual National Memory Screening Day on November 13 or another day during November, about 2,000 sites in 46 states will offer confidential memory screenings, education about Alzheimer's disease and successful aging, and access to local resources. Among them, all of Kmart's 1,100 pharmacies nationwide will be holding memory screenings, as well as other types of health screenings, as part of the chain's Gold K Day on November 16.

The face-to-face screening takes about five minutes and consists of a series of questions and tasks administered by a qualified healthcare professional, such as a doctor, nurse practitioner, pharmacist or social worker. AFA emphasizes that these screenings do not represent a diagnosis. Individuals who score below normal or who still have concerns are encouraged to pursue follow-up evaluations.

Last year, some 21,000 people participated in memory screenings at more than 700 sites nationwide on AFA's National Memory Screening Day. An estimated 10 percent of those screened were advised to follow up with a health care professional for further evaluation.

The Alzheimer's Foundation of America is a national nonprofit organization headquartered in New York and made up of hundreds of member organizations that provide hands-on programs to meet the educational, emotional, practical and social needs of families affected by Alzheimer's disease and related illnesses. AFA's services include a toll-free hot line, counseling, educational materials, a free caregiver magazine, and professional training.

Alzheimer's Foundation of America