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Neuroplasticity, Brain Fitness and Cognitive Health News

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Cognitive screenings and Alzheimer’s Disease

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.”

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4 Responses

  1. Krista says:

    I always enjoy your blog.

  2. chrissy says:

    Hi Alvaro, I live in Aus­tralia. Do you know how the lat­est cog­ni­tive screen can be accessed here ?

  3. Alvaro says:

    Chris­sy, I encour­age you to con­tact your local Alzheimer’s Asso­ci­a­tion or your health provider — they should be able to direct you appro­pri­ate­ly.

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As seen in The New York Times, The Wall Street Journal, BBC News, CNN, Reuters,  SharpBrains is an independent market research firm tracking how brain science can improve our health and our lives.

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