Assessments needed to detect memory problems earlier
Joseph Hoyle, MD
As a family doctor, I consider early detection of memory problems important to the well-being of my older patients.
Joanne Pike, DrPH, of the Alzheimer’s Association, stated that “early detection of cognitive decline offers numerous medical, social, emotional, financial and planning benefits, but these can only be achieved by having a conversation with doctors about any thinking or memory concerns and through routine cognitive assessments.”
As individuals and as a society, these benefits are important to achieve, at least in part because of family caregiving challenges ahead. In 2016, a National Academies of Sciences, Engineering, and Medicine expert committee concluded that “if the needs of caregivers are not addressed, we risk compromising the well-being of our elders and their families.”
However, a national survey done by the Alzheimer’s Association found that among older patients, 86 percent are not receiving memory assessments during routine health checkups. Of those with memory concerns, 85 percent do not bring this up with their provider and 40 percent have ever discussed it with their health care provider.
Although most primary care physicians probably do not try to avoid doing a memory assessment, the survey found that those who choose not to assess memory do so for the following reasons:
- Lack of symptoms or complaints from a patient – 68 percent.
- Lack of time during a patient visit – 58 percent.
- Patient resistance to testing – 57 percent.
Let’s take these one at a time. If you have a concern, please bring it up, because this helps me serve you. Time during an office visit is precious and I want to serve my patients, give them hope, and help them live meaningful lives. If you have a concern about a loved one, go with the person to an office visit. Even if you don’t have a concern, consider requesting a routine memory assessment, perhaps by scheduling a free Medicare wellness visit during which assessments are done.
Regarding time constraints, your interest in memory might help your provider prioritize this as well. Before I even walk in the room, my patients address most preventive services with their medical assistant or nurse.
I am very thankful to have a team-based approach at HopeHealth, as estimates are that a primary care provider with 2,500 patients would need more than 7 hours per work day to complete all of the recommended preventive services and nearly 22 hours per work day to provide preventive services and chronic disease management.
So, there’s much to discuss as I help my patients balance their most recent concerns with their chronic conditions and well-being issues, such as memory.
Regarding the third issue, patient resistance to testing, the survey found that physicians reported a 57 percent resistance rate to initial assessment, and patient refusal rates for follow-up testing were also significant at 34 percent. I am not sure why this is, but perhaps it highlights doubts about the benefits of early detection.
As a doctor, I encourage you to work with your provider to detect memory problems earlier.
Don’t miss the opportunity to discuss your memory with your doctor!
Dr. Joseph Hoyle, MD, MPH, is a board-certified family physician at the HopeHealth Medical Plaza in Florence. He volunteers with Helping Florence Flourish and is a member of the South Carolina Medical Association and the American Academy of Family Physicians.