F
indings from the Alzheim-
er’s Association 2019 Al-
zheimer’s Disease Facts
and Figures report show that, despite a
strong belief among seniors and primary
care physicians that brief cognitive as-
sessments are important, only half of
seniors are being assessed for thinking
and memory issues, and much fewer re-
ceive routine assessments. In addition to
providing an in-depth look at the latest
statistics on Alzheimer’s prevalence,
incidence, mortality, costs of care, and
impact on caregivers nationally and in
New York, the Facts and Figures report
examines awareness, attitudes, and uti-
lization of brief cognitive assessments
among seniors age 65 and older and pri-
mary care physicians.
A brief cognitive assessment is a
short evaluation for cognitive impair-
ment performed by a health care pro-
vider that can take several forms — in-
cluding asking a patient about cognitive
concerns, directly observing a patient’s
interactions, seeking input from family
and friends or using short verbal or writ-
ten tests that can be administered easily
in the clinical setting. An evaluation of
cognitive function is a required compo-
nent of the Medicare Annual Wellness
Visit, but findings from the report show
that only 1 in 3 seniors are aware these
visits should include this assessment.
The report also found, however,
that among both seniors and primary
care physicians there is widespread un-
derstanding of the benefits of early de-
tection of cognitive decline and the im-
portance of brief cognitive assessments.
In fact, 82 percent of seniors believe it
is important to have their thinking and
memory checked, and nearly all primary
care physicians (94 percent) consider it
important to assess all patients age 65
and older for cognitive impairment.
The Facts and Figures report also
reveals a troubling disconnect between
seniors and primary care physicians re-
garding who they believe is responsible
for initiating these assessments and reti-
cence from seniors in discussing their
concerns. The survey found that while
half of all seniors (51 percent) are aware
36 WNY Family March 2020
Cognitive Impairment:
Thinking & Memory Assessment
Should Become A Routine Part of
Primary Care for Seniors
of changes in their cognitive abilities
— including changes in their ability to
think, understand or remember — only
4 in 10 (40 percent) have ever discussed
these concerns with a health care pro-
vider, and fewer than 1 in 7 seniors (15
percent) report having ever brought up
cognitive concerns on their own.
Instead, most seniors (93 percent)
say they trust their doctor to recommend
testing for thinking or memory prob-
lems if needed. Yet fewer than half of
primary care physicians (47 percent) say
it is their standard protocol to assess all
patients age 65 and older for cognitive
impairment. Only 1 in 4 seniors (26 per-
cent) report having a physician ever ask
them if they have any concerns about
their cognitive function without seniors
bringing it up first.
“While many people are nervous
talking about cognitive changes, it is
crucial that we talk openly and frankly
about this,” says Sarah Harlock, Pro-
gram Director at the Integrative Center
for Memory at Dent Neurologic Institute
and a member of the Board of Directors
for the Alzheimer’s Association Western
New York Chapter. “There are many
things that can cause changes to memory
and thinking, such as vitamin deficien-
cies, medications, sleep apnea, thyroid
issues, anxiety, depression and more. If
addressed early, sometimes cognitive
changes can be reversed. And for those
changes caused by vascular or neuro-
logical conditions, treatments and life-
style changes are most effective in the
early stages.” Ms. Harlock says cogni-
tion should be thought of as a vital sign
like your temperature, blood pressure, or
heart rate and that the Medicare Annual
Wellness visit is a great time for patients
and healthcare providers to discuss cog-
nitive health.
Social workers are also available at
the WNY Chapter office to work with in-
dividuals and families to help them navi-
gate these sometime difficult conversa-
tions. Katie Keith Badeau is the director
of care consultations at the Chapter. “If
you are unsure how to bring up the con-
versation with your loved one or how to
best communicate your concerns with