According to a massive, new analysis, 91 percent of people over age 65 with clear cognitive impairment—consistent with clinical dementia—NEVER get diagnosed!
I suppose that when you think about the daily, verbal missteps of our current President of the United States, that finding might not seem so shocking.
But it really is!
Because it means that more than 9 out of 10 people in America with dementia don’t even know they have it.
And that’s a DISASTER for their treatment and prognosis—and for our healthcare system, too!
Here’s what you can do about it…
Clear signs of dementia continue to be overlooked
For this recent analysis, published in the Journal of Alzheimer’s Disease, researchers analyzed medical data on more than six million Americans ages 65 or older. All the participants had cognitive impairment consistent with dementia (CICD), but no history of stroke, cancers, neurological conditions, or brain damage.
At the start of the study, all the participants took cognitive tests via telephone to assess brain function. The researchers identified those who scored less than 6 points on the testing as having CICD. Then, in a survey, they noted if the participants had ever received a dementia diagnosis from their physician.
Overall, they found that 91.4 percent of people with clear signs of dementia on testing NEVER received an official diagnosis from their doctor!
(I should note that sometimes, someone other than the person who took the cognitive test—typically a family member—responded to the survey instead. But even in those cases, the rate of missed dementia was still a significant 75 percent.)
It turns out, men were more likely to experience a missed diagnosis, compared to women. And those who did not graduate high school also had a slightly higher estimated rate of a missed diagnosis.
Now, the researchers spent a lot of time exploring the connection between higher education levels (and socio-economic status) and greater access to healthcare resources. But in my view, the differences between these two educational subgroups were very slight. And by focusing on them, it misses the forest for the trees.
Instead, we should really keep the focus on why—and how—more than 90 percent of the ENTIRE GROUP with signs of dementia NEVER received a diagnosis!
Lack of routine, mainstream screenings
The researchers said the problem of missed diagnosis occurs because dementia screening isn’t a routine part of annual medical examinations for older adults. And I quite agree with that part of the analysis…
We should do a much better job of screening older adults for cognitive decline. But I’m not talking about using the dreadfully inaccurate blood protein testing, expensive PET scans, or grueling spinal taps.
Heck, even the health insurance industry figured out long ago how to test for dementia risk…
We DO have safe, accurate ways to assess dementia risk
I began investigating the value of long-term care (LTC) insurance several years ago—after our friend, J. P. Morgan (the 5th), and our own financial advisors, pointed out a new LTC plan that had a life insurance policy wrapped around it.
And, when I decided it was necessary, the insurance company put me through a long, merciless telephone interview to test my cognitive function before letting me get a policy.
A robotic insurance clerk with little medical knowledge (and even less sense of humor) conducted the test over the phone. And I can tell you, it was a lot more difficult to get through that insurance test than it was to get through any of the clinical assessments, administered by real doctors, that I’ve been through over the years! Thankfully, I managed to pass it. (But I recommend doing it sooner, rather than later, if you, too, want LTC insurance!)
My point is—there are plenty of safe, accurate ways to assess dementia risk. And some companies (like my insurance company) are already using them!
In the end, however, we can’t rely on mainstream medicine to protect us from cognitive decline. (We can’t even count on them to diagnose us!)
So, as always, it’s important to become your own health advocate and learn as much as you can about conditions that may affect you in the years to come.
“Self-Reported Dementia-Related Diagnosis Underestimates the Prevalence of Older Americans Living with Possible Dementia.” J Alzheimers Dis. 2021;82(1):373-380. doi.org/10.3233/JAD-201212.