Alzheimer's, Dementia & Mental Health
Alzheimer’s Foundation Calls for Congressional
Policy on Dementia Screening
New report ‘shatters unsubstantiated criticism’ and
emphasizes safety and cost-effectiveness of screening
Dec. 9, 2008 - As the nation faces a public health
crisis related to Alzheimer's disease, a new report released today by
the Alzheimer's Foundation of America (AFA) disputes an ongoing
controversy over the value and utilization of memory screenings. The
report, according to AFA, “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.”
The study, entitled "Memory Matters," sheds light
on the debate as the nation's aging population, - the most at risk for
the chronic brain disease - is booming. Americans in general are also
anxious about healthcare concerns and costs.
"This is a real world problem of escalating
proportions that requires real world solutions," said Richard E. Powers,
M.D., chairman of AFA's Medical Advisory Board and one of the authors of
the report. "Our nation must elevate age-related health issues to a high
priority, and memory screenings need to be a critical part of that
discussion."
Eric J. Hall, AFA's president and CEO, said the
report serves as a "wake up call" to the public and medical
professionals, as well as to policymakers.
"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."
The release of the report comes just in time for
holiday gatherings -- a time when many families recognize changes, or
possible warning signs of dementia, in their loved ones. Awareness of
warning signs is not a substitute for a structured screening or
consultation with a primary care provider, according to the authors.
Current research supports memory screenings "as a
simple and safe evaluation tool that assesses memory and other
intellectual functions and indicates whether additional testing is
necessary," the authors said. "Screenings also can reassure the healthy
individual and promote successful aging."
Performed in medical or community settings, a
screening typically consists of a series of questions and tasks and
takes about five to ten minutes to administer.
One main argument against memory screening is the
unsubstantiated assertions of potential adverse consequences, the report
said. However, the authors emphasized that screening results do not
represent a diagnosis.
"Screening tests in general simply help determine
whether diagnostic tests should be considered," the authors said. "A
'positive' result from a memory screening should never be interpreted as
a diagnosis of Alzheimer's disease or a related illness or other
illnesses -- no more than a 'positive' mammogram means an individual has
breast cancer."
Some conditions that cause symptoms of dementia,
such as hormone imbalances and vitamin deficiency, can be reversed.
Alzheimer's disease, the most common cause of dementia, is irreversible.
The incidence of dementia doubles approximately every five years in
individuals between the ages of 65 and 95.
"It is irresponsible to leave the disease
undetected to the extent it is now when there are safe tools available
to increase earlier detection," the authors declared. "The
implementation of screening programs in the community healthcare system
can rectify the failure of current diagnostic practices...and
significantly improve case identification."
According to the study, it is estimated that missed
diagnoses are greater than 25 percent of the dementia cases and may be
as high as 90 percent.
It emphasized that early identification of dementia
benefits the person with the disease, the caregiver, the family and
society, including cost benefits, noting that most researchers agree
that most available medications for Alzheimer's disease are best given
when the individual has mild symptoms. Other benefits include adoption
of healthy lifestyles; participation in support groups; home safety
modifications; and long-term care planning.
Citing the absence of a national strategy on
dementia screening in particular and dementia in general, the authors
suggested a national policy that includes forming a panel of consumers
and experts to craft screening recommendations; guidance by the Centers
for Medicare & Medicaid Services on when providers should screen for
cognitive impairment; recommendations to promote intellectual health;
and medical school training on dementia and memory problems.
AFA officials noted that community-based
screenings, such as those provided on AFA's National Memory Screening
Day each November, have tremendous value.
"They serve as a catalyst for participants to then
raise the issue of memory concerns with their primary care providers.
That is powerful in and of itself," Hall said.
In addition, Powers said, "Screenings offer an
opportunity to deliver positive messages to people that they should make
lifestyle changes to protect their brains as much as possible."
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 and educational information at nearly
2,200 community sites nationwide. During the prior 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.
The study was authored by Richard E. Powers, M.D.,
J. Wesson Ashford, M.D., Ph.D., chairman of AFA's Memory Screening
Advisory Board, and Susan Peschin, MHS, AFA's vice president of public
policy. The full report is available for download at www.alzfdn.org.
The Alzheimer's Foundation of America is a New
York-based national nonprofit organization focused on providing optimal
care to individuals with Alzheimer's disease and related illnesses, and
their families, and is made up of more than 950 member organizations
nationwide. For more information, call 866-AFA-8484 or visit
>> Web Site:
http://www.alzfdn.org/
>>
Click for pdf copy of the report on Dementia Screening
