Almost all people with mild cognitive impairment (MCI) are not properly diagnosed, which can increase their chances of developing Alzheimer’s disease in the future.
Two recent studies found that 92 percent of people suffering from MCI – a condition in which someone has mild problems with memory and decision making – which can progress to dementia over time, are not being diagnosed in early stages. , which could prevent people from accessing new treatments. which can delay cognitive decline if detected early.
In it first study, researchers used data from the Health and Retirement Study, a long-term survey of 20,000 people in the US, to build a model using a wide range of health and age factors that predicted the number of anticipated impairment diagnoses. mild cognitive impairment among people over 65 years of age. . The team determined that 8 million people would suffer from the condition.
They then analyzed data from Medicare enrollees ages 65 and older in the program between 2015 and 2019 to determine how many people were actually diagnosed with mild cognitive impairment.
Comparing their data, they found that mild cognitive impairment was missed in 92 percent of cases. Only eight percent of the people their model predicted would develop MCI were actually diagnosed with the condition, indicating that approximately 7.4 million people were suffering from cognitive impairment but were unaware of it.
Ying Liu, a statistician at the University of Southern California and a researcher on both studies, said, “We knew it was bad, but we didn’t know it was that bad.”
The scientists also found that the percentage of missed cases was even higher among black and Hispanic enrollees.
He second studyalso published by Liu and his team, examined Medicare claims from 226,756 primary care physicians with patients age 65 and older and compared MCI diagnoses with their model.
Again, they found that only eight percent of the predicted cases were actually diagnosed with mild cognitive impairment. Additionally, they found that only 0.1 percent of doctors diagnosed the condition as often as the team calculated they should.
People with mild cognitive impairment have minor problems with their mental abilities, such as memory and thinking. In these people, the difficulties are worse than normally expected for a healthy person her age, but they are not severe enough to be classified as dementia.
The Alzheimer’s Society estimates that between five and 20 percent of people aged 65 and older live with mild cognitive impairment.
While not a type of dementia, people with mild cognitive impairment are more likely to develop dementia, including Alzheimer’s disease, later in life. However, if people are diagnosed with mild cognitive impairment early, they may be able to implement lifestyle changes to reduce their risk.
Dementia affects an estimated 7 million people in the U.S., while approximately 5.8 million Americans suffer from Alzheimer’s disease.
And autopsies often reveal that people who die in old age have some type of cognitive impairment, including amyloid plaques, a hallmark sign of Alzheimer’s disease.
While people who have trouble remembering family members or who are lost can undergo cognitive testing, brain scans, and blood tests to diagnose dementia or Alzheimer’s, diagnosing mild cognitive impairment is more difficult.
People may notice that something is not right, but the symptoms are not severe enough to cause alarm and they can most likely still function independently. Because of this, many people who experience mild cognitive impairment often only visit their primary care doctor, rather than going to specialty memory care clinics.
General practitioners may not see many patients with dementia or have experience with mild cognitive impairment, causing a person’s condition to be overlooked.
A separate study reported that a patient’s cognitive status was formally assessed in less than a third of doctor visits. However, recent guidelines recommend that a cognitive assessment be performed at annual wellness checks.
The researchers of the two recent studies said: “Greater efforts are urgently needed to detect mild cognitive impairment earlier, especially for socioeconomically disadvantaged groups, who are at higher risk of diagnostic error.”
Previous research has shown that older black Americans are twice as likely to suffer from Alzheimer’s disease or other dementias than older whites. Older Hispanics are approximately 1.5 times more likely to have the disease than their white counterparts due to confounding factors of comorbidities and social issues, such as racism and discrimination.
Dr. Keith Vossel, director of the Alzheimer’s disease program in the department of neurology at the University of California, Los Angeles, previously told DailyMail.com that education and communication are two major obstacles for the minority population to overcome. and the healthcare community when it comes to the diagnosis and treatment of Alzheimer’s disease. treatment.
While mistrust leads to a lack of communication, Dr. Vossel said people from minority groups often ask why there are no doctors “that look like them” who work with dementia patients.
He added: “Unfortunately there are not enough neurologists and dementia specialists from underrepresented groups.” Doctors must be able to identify with their community.’
In addition to the lack of minority physicians, there is also a lack of access to physicians and healthcare facilities in general.
Addressing the high rates of dementia in minority populations will require a multifaceted approach and Dr. Vossel said it will require everything from establishing a stable educational system that meets the needs of all its students, developing measures to combat heart disease and diabetes, comorbidities that may contribute to dementia: Implement dementia screening at routine doctor visits and allow doctors to be reimbursed for those screenings.
However, there may be hope for people who develop dementia. An experimental Alzheimer’s drug developed by Eli Lilly slows cognitive decline by more than a third, the company announced in May.
In a phase 3 trial, the drug donanemab slowed the decline in patients’ ability to think clearly and perform daily tasks by 35 percent compared to a placebo.
Counties with the highest prevalence of Alzheimer’s cases
Miami-Dade County, Florida
Baltimore City, Maryland, USA
Bronx County, New York
Prince George’s C., MD
Hinds County, Mississippi
Orleans Parish, Louisiana
Orangeburg County, South Carolina
Imperial County, California
El Paso, Texas
Proportion (%), 2020
The data correspond to the proportion of the population aged 65 and over.