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Cognitive Impairment Screening

12/30/2014 by jhblogger

Do you ever feel you are losing that sharp edge to your memory? Perhaps you are not thinking as clearly as you might like. Has your spouse, son, daughter or close friend asked about or mentioned that you seem to be having problems remembering? Are you worried that your age or your chronic medical problems are negatively impacting your memory? These are all good reasons to ask your doctor to screen you for memory impairment.

There is considerable debate around the question of whether people should routinely be screened for memory problems. Arguments against screening including not having a cure for Alzheimer’s dementia and that the medications we currently have available are of limited effectiveness. When the United States Preventive Service Task Force (USPTF) reviewed whether to recommend routine screening for memory impairment, they could not definitively say yes or no.

What might be some solid reasons to inquire about being screened for memory problems? Remember, finding memory impairment does not mean you have an irreversible dementia. Other potentially reversible causes of memory impairment include side effects of medications, depression, thyroid and other endocrine disorders, and other acute and chronic illnesses. These and other potentially reversible causes of memory decline can be effectively treated once recognized. Almost half of people over the age of 80 years are identified as having some form of dementia making advancing age a good reason to be screened.

Screening negative for memory impairment can greatly reduce some of your health care concerns, at least in the short term. But what if you screen positive and your physician does not uncover a potentially reversible cause? What if further tests demonstrate a diagnosis of Alzheimer’s or other dementia? Is there any advantage to knowing early? Some potential advantages to knowing the diagnosis of dementia include:

• Other illnesses associated with memory impairment can be identified and treated;

• Starting medications to treat Alzheimer’s dementia early on may help slow (but not halt) progression of the disease;

• You can plan ahead for your needs including identifying your goals of care over the long term and updating your advanced directives;

• You can work with your lawyer to make certain your will and other legal documents are updated and kept current with your wishes;

• Family members and caregivers can be educated and prepared for future needs;

• Safety issues can be recognized and addressed.

Screening is quick and easy, involves several questions, and takes only 5-10 minutes. There are no current blood tests or radiologic examinations appropriate for screening. Further evaluation by your primary care physician and specialist referrals are readily available. A lot more research is needed to identify means to prevent dementia and effectively treat existing dementia. For now, keep yourselve informed and plan ahead. Discuss your concerns with your physician and consider, once you feel fully informed, being screened for memory impairment.

--Dr. Michael Lindberg; Physician-in-chief, Hartford HealthCare's Geriatric and Palliative Care Institute

For more information about scheduling a memory screening please call the Connecticut Center for Healthy Aging at 1-877-424-4641


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