Early Detection

Benefits of Early Detection

There are multiple benefits to early detection of Alzheimer’s disease and other memory problems.

Some conditions that cause symptoms of dementia, such as hormone imbalance, vitamin deficiency and infections, can be reversed. Some individuals with alcohol related dementia may stabilize or show small improvements in intellectual function over time if they maintain continuous sobriety; others demonstrate progressive cognitive loss. Once the cause of a memory problem is determined, treatment can begin. Early diagnosis boosts the chances of successful treatment.

If the memory problems stem from an irreversible dementia such as Alzheimer’s disease, the sooner an accurate diagnosis of “probable” Alzheimer’s disease is made, the easier it is to manage symptoms and plan for the future.

Here are some of the benefits of early detection:

  • Begin medical treatment. Identification of early stage dementia allows early aggressive use of most available treatments, which may slow progression of symptoms.
  • Have an open dialogue with healthcare providers. Individuals and their families can have discussions about treatment options, participation in clinical trials and medical care to meet the individual’s needs.
  • Become educated. Knowledge about the disease offers empowerment and helps prepare individuals with the disease and their families for what lies ahead.
  • Handle legal and financial issues. These include decisions about disposition of wealth and ensuring that documents such as a durable power of attorney and a living will are in place.
  • Plan for the future. Individuals with the disease have greater self-determination, gaining more input into care options, long-term care and end-of-life issues, while relieving family members of some of the decision making.
  • Embrace support groups. Individuals with the disease may be able to participate with peers in early-stage support groups or other programs that provide emotional and practical support, and stimulation.
  • Ensure safety. Homes can be modified to protect against wandering, falls, etc.
  • Make lifestyle changes. Individuals can focus on physical exercise, mental stimulation, diet, stress management and other healthy habits that may impact the course of symptoms.

Early detection also has numerous benefits to caregivers, other family members and society.

‘Memory Matters’ Report

This executive summary is excerpted from “Memory Matters,” a report released by the Alzheimer’s Foundation of America (AFA) in December 2008. The report was authored by Richard E. Powers, M.D., chairman of the AFA Medical Advisory Board, J. Wesson Ashford, M.D., Ph.D., chairman of the AFA Memory Screening Advisory Board, and Susan Peschin, MHS, AFA’s vice president of public policy. Many of the statements and themes in the report were developed by the AFA Memory Screening Advisory Board.

Executive Summary

Most persons with dementia remain undiagnosed by their primary care providers, and families often fail to recognize the significance of early cognitive symptoms. In response, there has been a growing interest in screenings for memory problems.

The proposed answer is that screening for memory dysfunction, Alzheimer’s disease and other dementias is important, but raises pragmatic, ethical as well as theoretical considerations that need to be addressed before general screening practices can be widely implemented.

Screenings are occurring throughout the nation by local, independent organizations, often with minimal guidance or technical assistance like that provided by national organizations such as the Alzheimer’s Foundation of America (AFA) to groups participating in its screening initiative.

To refine the screening process in general, the screening of at-risk populations for dementia should become a cornerstone for early treatment or prevention of cognitive decline. Prospective prevention research will not be performed in a timely manner to confirm the value of screening so policymakers must propose the best possible option as a comprehensive approach to cognitive health.

Multiple types of screening interventions have been described in the medical literature, including person-to-person, telephone and computer-based. Screening is not a diagnosis, but can help lead to the referral of appropriate individuals for further evaluation or to the promotion of cognitive wellness. Screening should not produce adverse outcomes and published screening instruments can be completed in as little as five minutes.

Screening is a safe, cost-efficient intervention that can reassure the healthy individual, promotes successful aging and, when indicated, directs individuals to appropriate clinical resources.

Currently, there is no national strategy on dementia screening in particular and dementia in general, a public health problem related to an at-risk population on the threshold of a boom. It is irresponsible to leave the disease undetected to the extent it is now when there are safe tools available to increase earlier detection. There are several policy recommendations that, if implemented, would assist clinical efforts at early diagnosis and treatment for dementia, and promotion of cognitive wellness.

About Memory Screenings: National Memory Screening Day

The Alzheimer’s Foundation of America (AFA) initiated National Memory Screening Day in 2003 as part of its mission to provide “optimal care and services to individuals confronting dementia, and to their caregivers and families”…and as part of its focus on “Caring for the Nation.”

The event is held each November in recognition of National Alzheimer’s Disease Awareness Month.

AFA carries out this event in collaboration with local organizations and healthcare professionals across the United States.

Qualified healthcare professionals at thousands of participating sites offer free, confidential memory screenings to individuals with memory concerns or who want to check their memory. Sites also provide follow-up resources and educational materials, including information about memory loss, caregiving and successful aging.

On AFA’s annual National Memory Screening Day:

  • The screenings are face-to-face and take place in a private setting; only the individual being tested and the clinician are present.
  • The person who administers the screening will review the results with you. Individuals with below-normal scores and those who still have concerns are encouraged to follow up with their primary care provider for an evaluation.
  • Results of the memory screenings are confidential. You will receive the screening results to bring to your healthcare professional.

National Memory Screening Day is the highlight of AFA’s ongoing national initiative to promote early detection of Alzheimer’s disease and related illnesses, and to encourage appropriate intervention, including medical treatments, social services and other resources, as well as raise awareness of successful aging.

AFA believes that memory screenings are a significant first step toward early diagnosis of Alzheimer’s disease or a related dementia, or another type of condition that is causing memory loss. A memory screening is not used to diagnose any particular illness and does not replace consultation with a qualified physician or other healthcare professional.

About Memory Screenings: Screening Snapshot

A memory screening is a simple, safe and non-invasive evaluation tool that assesses memory and other intellectual functions, and indicates whether additional testing by a qualified healthcare professional is necessary.

Various types of healthcare professionals provide memory screenings, including social workers, pharmacists, physician assistants, nurse practitioners and doctors.

A screening consists of a series of questions and/or tasks designed to test memory, language skills, thinking ability and other intellectual functions. Screening tools include the GPCOG, MINI-COG and MIS.

Think you should take a memory screening? These questions might help you decide. If you answer “yes” to any of them, you might benefit from a memory screening.

  • Am I becoming more forgetful?
  • Do I have trouble concentrating?
  • Do I have difficulty performing familiar tasks?
  • Do I have trouble recalling words or names in conversation?
  • Do I sometimes forget where I am?
  • Have family or friends told me that I am repeating questions or saying the same thing over and over again?
  • Am I misplacing things more often?
  • Have I become lost when walking or driving in a familiar neighborhood?
  • Have my family or friends noticed changes in my mood, behavior, personality or desire to do things?

Medicare Annual Wellness Exam

The Patient Protection and Affordable Care Act, also known as “Health Care Reform,” signed into law in 2010 makes a few upgrades to Medicare with a focus on prevention and early detection.

The Facts:

  • Medicare will now pay for a wellness exam once every 12 months for beneficiaries.
  • There are no deductibles or co-payments for this visit.
  • The exam includes the creation or update of a personalized prevention plan based on your current health and risk factors.
  • The exam also includes the detection of any cognitive impairment.
  • The visit may be performed by a doctor or any other healthcare provider recognized by Medicare.

More Details About the Detection of Any Cognitive Impairment:

  • Your doctor may do an assessment of your cognitive function through direct observation while also taking into consideration any concerns raised by you, your family, caregivers or others.
  • The detection of a cognitive impairment is not necessarily a diagnosis of Alzheimer’s disease. Some memory problems can be readily treated, such as those caused by vitamin deficiencies or thyroid problems. Other memory problems might result from causes that are not currently reversible, such as Alzheimer’s disease. If your practitioner suspects a problem, additional tests can be run to more accurately determine the cause of the impairment.
  • If you have questions or concerns about your memory, don’t hesitate to ask your doctor or other healthcare professional during this visit or at any other time.

What Else to Expect During the Visit:

  • A review of your personal medical and family history, current health conditions and medical concerns, and current prescription drugs, over-the-counter drugs, vitamins and supplements.
  • A check of your blood pressure, vision, weight and height to establish a baseline for future comparison.
  • Discussion of the status of your cancer screenings, shots and other preventive screenings and services.
  • Recommendations for further tests, depending on your general health and medical and family history. Note: Further tests or doctors’ visits not included in the annual wellness exam may require some out-of-pocket costs. Ask your doctor or Medicare if you have questions about coverage.
  • Creation or updating of a personalized prevention plan, including a checklist of suggested screenings, immunizations and other preventive services.

Preparing for the Visit:

  • Bring your medical records, including immunization records, and your family medical history, which can help your doctor determine suggested screenings.
  • Bring a list of any prescription drugs, over-the-counter drugs, vitamins and supplements that you currently take, noting the conditions they related to, dosage and any side effects. Also consider bringing the actual pill bottles.
  • Notify your doctor if you have exhibited any of the following symptoms of dementia or prepare a list of your own concerns:
    • Memory loss, especially of recent events, names, placement of objects and other new information
    • Confusion about time and place
    • Struggling to complete familiar actions, such as brushing teeth or getting dressed
    • Trouble finding the appropriate words, completing sentences and following directions and conversation
    • Changes in mood and personality, such as increased suspicion, rapid and persistent mood swings, withdrawal and disinterest in usual activities
    • Difficulty with complex mental assignments, such as balancing a checkbook or other tasks involving numbers

In Order to Qualify for the Visit:

  • You must have been receiving Medicare Part B benefits for at least 12 months.
  • li>If you have had your initial, one-time “Welcome to Medicare” physical exam within the past 12 months, you will be eligible for your first annual wellness exam one year from the date of that initial visit.

    li>You are eligible for a wellness exam once every 12 months.