Dec 10, 2008
By: Alvaro Fernandez
The Alzheimer’s Foundation of America just released a thoughtful report advocating for widespread cognitive screenings after the age of 65 (55 given the right conditions).
According to the press release,
- “The report shatters unsubstantiated criticism and instead emphasizes the safety and cost-effectiveness of these tools and calls on Congress to develop a national dementia screening policy.”
- “Lifting the barriers to early detection is long overdue, Hall said. “Conversations about brain health are not taking place. We must educate and empower consumers to talk openly about memory concerns, particularly with primary care providers, so they get the attention and quality of life they deserve.
- “Demand for screenings is evidenced by the success of AFA’s recent sixth annual National Memory Screening Day held on November 18, during which an estimated 50,000 people were given free confidential memory screenings at nearly 2,200 community sites nationwide. During last year’s event, approximately 16 percent of individuals who had a face-to-face screening scored positive and were referred to their primary care providers for follow-up. An AFA survey of participants revealed that fewer than one in four with self-reported memory complaints had previously discussed them with their physicians despite recent visits.”
Excellent report available: here
Please note that the Alzheimer’s Association recently argued in the opposite direction (no screenings) — which probably triggered this response.
We see emerging trends that suggest the position in favor of cognitive assessments may in fact gather momentum over the next few years: widespread computerized cognitive screenings in the US Army, insurance companies like OptumHealth adding such tools to its clinical decision-making systems, polls such as the American Society of Aging’s a couple of years ago indicating a very strong demand for an “annual mental check-up”, the availability of useful assessment tools and research-based preventive advice.
The starting point is to understand what those assessments are NOT: they are not diagnostic tools. When used properly, they can be used as a baseline to track performance in a variety of cognitive domains over time, so that both the individual AND the physician are not blinded by a one-time assessment, comparing an individual with his or her peers (instead of his or her past performance) when serious symptoms have frequently already been going on for a while.
Our contributor Dr. Joshua Silverman, from Albert Einstein College of Medicine, recently generated a nice debate on the topic by asking our readers their reaction to these 3 questions:
1) Even if my cognitive abilities were declining, knowledge of this would leave me worse off.
2) I am concerned that family, friends, physicians, employers, or insurers would treat me differently if they found out I had cognitive decline.
3) Understanding my cognitive strengths and weaknesses will motivate me to establish and adhere to a personalized brain fitness program.
You can read his whole post, and the thoughtful answers, here: Can We Pick Your Brain regarding Cognitive Assessments?
Joshua wrapped-up the debate by saying:
“Since there is a diversity of views, it is difficult to summarize. However, most responders emphasize that knowledge of one’s cognitive status is empowering, regardless of age, condition, or whether one’s cognition is improving or declining.
I am in total agreement with this imperative to mind the brain, and understanding the many potential concerns that follow will allow our society to manage this information responsibly.
An important caveat is that as SharpBrains enthusiasts, we are not representative of the prevailing opinions in most communities. We need better research to support this claim, but my impression is that many still view cognitive decline as inevitable and unmodifiable and would not be prepared to use objective feedback on their mental abilities to empower or motivate.
Thanks to SharpBrains and a growing segment of the healthcare, private sector, and government universes, we are witnessing culture change and a shift toward preventative approaches.
I know I don’t need to tell this community that successful brain aging is achievable, but each of us should consider how we can transmit this message to those around us.”