Possibly the most daunting yet one of the most common risk seniors face as they age is significant cognitive decline. Our minds age along with our bodies, sometimes at a faster rate, accelerated by various forms of dementia and other cognitive impairments. Dementia is defined by a significant decline in one or more cognitive domains that interferes with a person’s independence in daily activities. While some diseases such as Alzheimer’s disease have no known cure, it and other cognitive disorders can be treated if discovered early enough.
Cognitive screenings for older adults are nothing less than essential for catching and treating disorders and diseases as early as possible. Those who receive treatment during Stage 1 of Alzheimer’s disease, for example, can go on to live an incredibly fulfilling and reasonably independent life. Most importantly, they and their families have time to prepare for later stages of Alzheimer’s financially, mentally and emotionally. This guide will help you and your loved ones begin to understand the importance of screenings and recognize the symptoms of cognitive impairment.
Why Screenings Are Important
Dementia affects an estimated 2.4 to 5.5 million individuals in the United States, according to the U.S. Preventive Services Task Force (USPSTF). Of these people, a significant number who already have dementia or are developing it go undiagnosed. A 2018 survey conducted by the Alzheimer’s Association found that while 82% of seniors said they believe cognition screenings are important, only 16% of seniors said their physicians regularly performed screening. Furthermore, studies find that at least 50% of the time physicians overlook signs of cognitive decline in older adults.
What does this mean for seniors? Essentially, it means that each senior, their family members and loved ones must be their own greatest advocate for their cognitive health, since the vast majority of screenings only occur when symptoms of cognitive impairment are evident.
Cognitive screenings for older adults, especially when conducted regularly, can identify brain conditions and allow seniors and family members to take proper steps to combat the conditions and prepare for eventualities of worsening conditions. However, there is some debate in the scientific community about the efficacy of regular cognitive screenings. In their recommendations on screenings for cognitive impairments in older adults, the USPSTF declined to fully endorse or oppose universal cognitive screenings. The USPSTF found a lack of evidence that universal cognitive screening for seniors would improve patients’ quality of life or help them get better care. While this may seem counterintuitive, there’s a reasonable explanation for the lack of endorsement. The study the USPSTF based their recommendations on found there was not sufficient evidence that seniors in a screening group had improved quality of life or lower rates of hospitalizations or emergency department visits a year after the screening was conducted when compared with seniors who were not screened. Boiled down, this means that screenings alone do not yield applicable benefits unless they are followed with appropriate care.
At the very least, negative screening tests can alleviate concerns. At best, screenings can identify the cause of cognitive impairments and allow physicians and patients to make a plan. There are a wide variety of causes for cognitive impairment, ranging from medication side effects, endocrine imbalance and sleep disorders to delirium, depression, anxiety, Alzheimer’s disease, other forms of dementia, and more. Depending on the cause and at what point the impairment is identified, a number of next-step options can be available. According to the National Institute on Aging, options typically include:
- Treating the underlying disease or health condition.
- Managing comorbid conditions more effectively.
- Averting or addressing potential safety issues.
- Allowing the person to create or update advance directives and plan long-term care.
- Ensuring the person has support services and a care network, as well as help with medical, legal and financial concerns.
- Working with the person and their caregivers to develop strategies to improve quality of life, modify the person’s lifestyle, make home safety modifications, and manage emotions related to the dementia diagnosis.
- Referral to a behavioral health specialist, who may be able to provide the person with memory tools that can help individuals become more organized to better manage symptoms of memory loss.
- Ensuring the caregiver receives appropriate information, referrals, and support coping with a dementia diagnosis and managing stress.
- Encouraging participation in clinical research.
Types of Cognitive Screening Tests
The most commonly used screening tests include the Mini-Mental State Examination (MMSE) and the clock-drawing test (CDT). Most screening tools involve patients performing a series of tasks that assess one or more aspects of cognitive functions. If a patient tests positive in the initial screening, additional blood tests, MRIs, radiology, and more in-depth neurophysiological tests are conducted by specialist physicians. Other screening tests regularly administered to seniors include:
- Memory Impairment Screen (MIS)/MIS by Telephone (MIS-T)
- Mental Status Questionnaire (MSQ)
- Mini-Cog Verbal Fluency
- 8-Item Informant Interview (AD8)
- Functional Activities Questionnaire (FAQ)
- 7-Minute Screen (7MS)
- Abbreviated Mental Test (AMT)
- Montreal Cognitive Assessment (MoCA)
- Telephone Instrument for Cognitive Status (TICS)
- Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)
All these screening tools are simply meant to identify the presence of some form of cognitive impairment — not to discover the exact impairment or treat impairments of any kind. All seniors and family members should ask physicians to conduct cognitive screening tests during their annual wellness visit, which everyone above age 65 should schedule. For a general idea of what screening tests might look like, view the Alzheimer’s Association’s Cognitive Assessment Toolkit.
The Right Care for Cognitive Impairment at Sedgebrook
For those who have been diagnosed with cognitive impairment, including Alzheimer’s or other forms of dementia, as well as their families, it’s important to know that help is right at your fingertips. Here at Sedgebrook, our approach to assisted living and memory care puts personalized, resident-centered care at the forefront. Our qualified team of state-certified dementia care specialists treats residents with the utmost respect and compassion. We understand better than most the challenges of cognitive impairment, so we make extra efforts to bring peace of mind to seniors and their families. To learn more about memory care here, fill out the form below, and we’ll be in touch with you soon.