How Screenings Can Lead to Further Evaluation and Promote Cognitive Wellness
This executive summary is excerpted from “Memory Matters,” a report released by the Alzheimer’s Foundation of America (AFA) in December 2008. The report was authored by Richard E. Powers, M.D., chairman of the AFA Medical Advisory Board, J. Wesson Ashford, M.D., Ph.D., chairman of the AFA Memory Screening Advisory Board, and Susan Peschin, MHS, AFA’s vice president of public policy. Many of the statements and themes in the report were developed by the AFA Memory Screening Advisory Board.
Click here to read the complete report.
Most persons with dementia remain undiagnosed by their primary care providers, and families often fail to recognize the significance of early cognitive symptoms. In response, there has been a growing interest in screenings for memory problems.
The proposed answer is that screening for memory dysfunction, Alzheimer’s disease and other dementias is important, but raises pragmatic, ethical as well as theoretical considerations that need to be addressed before general screening practices can be widely implemented.
Screenings are occurring throughout the nation by local, independent organizations, often with minimal guidance or technical assistance like that provided by national organizations such as the Alzheimer’s Foundation of America (AFA) to groups participating in its screening initiative.
To refine the screening process in general, the screening of at-risk populations for dementia should become a cornerstone for early treatment or prevention of cognitive decline. Prospective prevention research will not be performed in a timely manner to confirm the value of screening so policymakers must propose the best possible option as a comprehensive approach to cognitive health.
Multiple types of screening interventions have been described in the medical literature, including person-to-person, telephone and computer-based. Screening is not a diagnosis, but can help lead to the referral of appropriate individuals for further evaluation or to the promotion of cognitive wellness. Screening should not produce adverse outcomes and published screening instruments can be completed in as little as five minutes.
Screening is a safe, cost-efficient intervention that can reassure the healthy individual, promotes successful aging and, when indicated, directs individuals to appropriate clinical resources.
Currently, there is no national strategy on dementia screening in particular and dementia in general, a public health problem related to an at-risk population on the threshold of a boom. It is irresponsible to leave the disease undetected to the extent it is now when there are safe tools available to increase earlier detection. There are several policy recommendations that, if implemented, would assist clinical efforts at early diagnosis and treatment for dementia, and promotion of cognitive wellness.