Dementia, who?

by Devin Bowers, Innovation Fellow

It is not often that we hear the question asked “Do you have any concerns about your memory?” in the office of a primary care physician (PCP). Memory loss can be misconstrued by PCPs as a norm­­­­al part of aging; therefore it is overlooked in the myriad of other chronic conditions affecting older adults. As we age, recalling information or memories can take longer, but loss of short-term memory and difficulty performing daily tasks can be signs of cognitive impairment due to a form of dementia such as Alzheimer’s disease (AD). Click here to review the 10 Early Signs and Symptoms of Alzheimer's available from the Alzheimer’s Association.  The Patient Privacy and Affordable Care Act (ACA) entitles Medicare recipients to an Annual Wellness Visit (AWV), which includes a cognitive assessment. PCPs generally have very limited geriatric training, however they provide care to the majority of older adults.[i] In 24 to 72% of cases, PCPs fail to diagnose dementia and there is a lag of approximately 4 years between the onset of symptoms and receiving a diagnosis.[ii] PCPs fail to diagnose dementia for a variety of reasons.

  • Short office visits inhibit their ability to recognize signs of cognitive impairment.[iii] The median length of an office visit with a PCP is 15.7 minutes for patients aged 65 and older. [iv]
  • Appointment time spent with older adult patients is dedicated to other major chronic conditions such as diabetes, congestive heart failure, arthritis, and hypertension.3
  • Many lack appropriate training to screen for dementia.3
  • There is a general unwillingness to address a medical condition that is untreatable.[v]
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