CHICAGO – Too few people with signs of mental retardation or dementia are examined or experienced during routine medical visits if a problem is found, says a group of Alzheimer's experts who offered new advice on Sunday.
The idea is to get help sooner for people whose mind is slipping – even if there is no cure.
Although mental retardation can be an uncomfortable issue for patients and their doctors, the panel says GPs should take a thorough assessment when symptoms occur.
Patients and family members should push for an assessment if they fear the Symptoms could not age normally ̵
"Until you forget what the keys are for, you're too far away to attend to your own caring, we've probably lost a decade," that could have been budgeted, "said the panel's chief executive, Dr. Ing. Alireza Atri, a neurologist at the Banner Sun Health Research Institute in Arizona.
Not only memory can suffer when mental deterioration begins, Atri said.
"It's actually people's judgment that their character and personality are off" he said, sometimes years before being diagnosed with dementia.
Over 50 million people worldwide have dementia; Alzheimer's is the most common form. In the United States, nearly 6 million people have Alzheimer's and nearly 12 million have a slight Cognitive impairment, a common precursor.
In 2015, an Alzheimer's study using Medicare records revealed that only about half of the People who had been treated for Alzheimer's were told by their doctor that they had been diagnosed with the disease.
"All too often, doctors will hear of some symptoms or memory problems from patients or their spouse and say, 'You know you seem to me okay today'" "" "" "" "" "" "" "" "" "" "" "" "" "" "" "" "" "" "" Said James Hendrix, an Alzheimer Association science specialist who worked with the panel. In the meantime, the patient could be hospitalized, for example because she forgot to take diabetes medication because her mental retardation was not recorded.
"We keep hearing stories of people who take years to get an accurate diagnosis," said Nina Silverberg, a psychologist who runs Alzheimer's programs at the National Institute on Aging, which did not play a role in the guidelines.
Medicare has recently started treating mental health ratings as part of the annual wellness visit, but doctors are not required to do so. There was no guidance on how to do it, she said. In some cases, it might be as superficial as asking, "What is your memory?"
The panel was appointed by the Alzheimer's Association and included family physicians, aging specialists, nurses, and a psychiatrist. Comprehensive guidelines were released on Sunday at the group's international conference in Chicago; Details will be released later this year.
The guidelines do not recommend reviewing all. They describe what health workers should do when people describe worrying symptoms. These include: reviewing risk factors that may contribute to dementia or other brain diseases, including family history, heart disease and head injury; Pen-and-pencil memory tests; Imaging tests to detect small strokes or brain injuries that can lead to memory problems.
Dr. Michael Sitorius, head of family medicine at the University of Nebraska Medical Center, said that dealing with mental deterioration brings with it the challenge of caring for often frail elderly patients.
It's a difficult diagnosis for many doctors, he said, because it's a medical education focused on "trying to cure people and Alzheimer's and dementia are not curable."
He said he gives his elderly patients mental tests in their annual checks – but that sometimes patients or loved ones do not want to hear the results. In these cases, Sitorius is still treating related issues such as depression, medication, nutrition, and whether patients should continue driving.
He said the new guidelines are a welcome reminder to family physicians to address these issues earlier.
"Sure." "We could do better," he said.
A diagnosis should never be withheld for fear of depressing the patient,
"We encourage full disclosure," including diagnosis , Stage and Prognosis, he said.
At the urging of her daughter, Anne Hunt visited her family doctor in 2011 because of increasing forgetfulness.Hunt, 81, who once ran a cooking school in Chicago, remembers having memory tests had to deal with letters and numbers that she had her doctor do.
"I thought, 'Okay, that's it, I'm a vegetable," Hunt said, but the test results were inconclusive and there was no diagnosis.
"We have not done much," said Bruce Hunt, Anne's husband, until five years later, when her behavior worsened significantly – more memory lapses, she repeated herself and forgot sen, where to put things.
She was diagnosed with Alzheimer's after an imaging test showed brain changes often seen with the disease. Imaging tests are sometimes used along with mental tests to diagnose the disease or rule out other conditions.
IS IT GOOD TO KNOW?
"There is no pill they can take to make it go away, so some people think there is no indication to get a diagnosis," but that's not true, said the National Institute of Aging Silverberg. "It really offers an opportunity to plan."
Alzheimer's medicines such as Aricept and Namenda can alleviate symptoms but are not a cure.
Experts say that other benefits are a chance to experiment with experiments, solve finances, find caregivers, make homes safer, and use reminders and calendars to promote an independent life.
The Hunts joined support groups and a vocal ensemble, hoping that it would help them to try new things. They were better prepared than others. Long before their diagnosis, they transformed an old Chicago home into two spacious homes so they could "grow old" with the help of one of their daughters and their family.
Anne Hunt said she wanted to learn the truth about her diagnosis.
"It's unknowable to wonder why things happen to you and you do not understand them," she said. "I'd rather know and help me figure out how to control it as much as I can."
Follow Marilynn Marchione @MarchioneAP and Lindsey Tanner @LindseyTanner.
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