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SALT LAKE CITY — For the first time, the nation’s leading group of brain doctors is recommending everyone age 65 and older receive a yearly memory assessment.
“Up to now, it has been common for physicians to overlook memory complaints, or at least not seek if there’s a memory problem. And many physicians have felt that they shouldn’t be looking for such problems and didn’t know what to do when they found such problems,” explained Dr. Norman Foster, professor in the Department of Neurology and senior investigator of The Brain Institute at the University of Utah.
The Utah doctor, also a fellow of the American Academy of Neurology, authored the organization’s new guideline published last week.
According to the academy, nearly 7% of people in their early 60s worldwide have mild cognitive impairment, while the condition affects 38% of people ages 85 and older.
Foster said the Utah Department of Health also has a public awareness campaign underway urging those over age 65 to ask their physicians for annual memory checks.
That campaign began in March, said Kristy Russell, resource specialist with the Alzheimer’s Disease and Related Dementias program for the Utah Department of Health. Information about the campaign and resources can be found on the department’s website at agewell.health.utah.gov.
Russell also encouraged people younger than 65 who are experiencing medical problems to receive memory assessments, as serious memory diseases can be diagnosed at younger ages as well.
In the past, it’s been common for physicians to “just use their gut feelings to decide whether somebody has memory and thinking problems,” Foster recalled.
But the guideline recommends that they “go beyond that” by using a standard, three-minute test to determine whether someone has a problem causing memory loss.
There’s much that can be done to make their patients better, and to improve quality of their care.
–Dr. Norman Foster, professor in the Department of Neurology
The standard test used in Utah asks people to repeat three words and then remember them, draw a clock, put numbers and hands on the clock pointing to the time the physician requests, and then repeat the three words, Foster said.
The Alzheimer’s Association praised the guideline in a statement Wednesday, calling it “an important step toward improving patient outcomes, while also inviting important discussions about cognitive concerns, which seniors may not share otherwise.”
The association found in a report this year that despite a “widespread awareness” about the benefits of early detection, only 1 in 7 seniors say they receive regular memory assessments.
The American Academy of Neurology’s guideline tells neurologists and other medical providers what they should do if they find memory problems in their patients. Through the evaluation, doctors can work to identify conditions like depression, medication side effects, or major diseases like strokes or brain tumors, Foster said.
The evaluation can help doctors figure out if an underlying condition is causing a patient’s memory loss, or if it’s just a part of the normal aging process. Even sleep disorders and mood problems can affect memory and thinking.
Other problems like hearing loss and visual impairment can contribute to memory problems, Foster said. If those conditions are ruled out and a patient shows the first signs of a more serious brain disease like Alzheimer’s, the patient can know when to involve their family and plan for the future. And the doctor can work to improve their quality of life.
For those doctors, “there’s much that can be done to make their patients better, and to improve quality of their care,” Foster said. Some options include medication and research participation, he said.
According to Foster, the recommendation signifies that the health community is overcoming “a pervasive nihilism about memory problems and whether we can do something about them or know what causes them.”
“And that has changed dramatically in the past decade because we now recognize that we can identify the cause of significant memory problems, or ways to determine whether someone has Alzheimer’s disease or not with diagnostic testing, for example,” he said.
Doctors increasingly are recognizing that medications often cause memory problems that get mistaken for symptoms of Alzheimer’s disease, Foster added.
While treating conditions like brain disease, tumors, stroke and multiple sclerosis has been a priority for the neurologists, Foster said, “this guideline is the increasing recognition that early diagnosis and interventions are much more effective. So I think things have changed so we now know that one of our priorities as physicians is to identify and treat memory problems early.”
To decrease their risk of memory loss, Foster said, people should stay physically and socially active; make sure their blood pressure is “well-controlled” by eating a good diet; prevent or control diabetes; and stay updated on new treatments and research regarding memory problems.
