Health
Challenges for identifying patients with dementia and Alzheimer’s disease
In the United States, the presence of dementia and Alzheimer’s disease is already higher than the diagnosis rate. However, as the aging generation approaches higher risk levels and screening methods remain incomplete, there is increasing pressure to better analyze the presentation of memory loss.
In an interview with HCPLive so American Psychiatric Association (APA) 2022 Annual Meeting In New Orleans this week, Dr. Brent Forester, MD, Head of Geriatric Psychiatry at McLean Hospital, discussed the importance of proper screening in older patients complaining of memory loss. As he pointed out, the population of people with Alzheimer’s disease is expected to reach 15 million Americans by 2050. Approximately $ 340 billion is spent annually on the care of the current population.
“This one condition, which represents the sixth leading cause of death in the United States, is an economic catastrophe unless we can find a way to intervene in ways to diagnose people early and track or treat the disease.” Said Forester. “But the most important thing is to evaluate it.”
Forester explained that memory dissatisfaction is often associated with normal signs of aging by loved ones, but it is important to address it in a primary care setting and make a thorough assessment. Memory loss can be anything from thyroid problems to anxiety and depression to alcohol and substance abuse.
“The way I think about memory problems is that it’s just the tip of the iceberg, and below that is the whole world where you have to discover what’s causing it,” Forester said.
Care becomes more tricky if the diagnosis is dementia or Alzheimer’s disease. About half of all Americans with Alzheimer’s disease have not been diagnosed, and many have already been diagnosed for 20 years when the pathology of the disease is present in the brain.
There is no single blood test or scan available for this disease. Over the last decade, the review of population-based testing of dementia using commonly used cognitive tools to identify the initial risk of diagnosis has been scrutinized. This can lead to many false positives, Forester said.
“More and more people are developing targeted screening approaches using algorithms that include entering electronic medical records and extracting components of the medical history that may be at risk for dementia.” He explained. “The question is how to create a simple package (almost an algorithm) that primary care physicians can follow to avoid getting lost.”
The idea of these proposed screening tools is to treat patients and their loved ones to resources and care teams that help address the cognitive burden of dementia while paying attention to maintained quality of life. Is to help.
From there, services such as the Alzheimer’s Disease Association Dementia Care Counseling Program can provide families with assessments linked to primary care physicians who act as a “roadmap” for all parties, Forester said. rice field.
Forester also highlighted several currently available collaborative care models that can provide timely, rapid and economically sound care to new patients with dementia or Alzheimer’s disease. That said, more work needs to be done at the systemic level to actually realize these pathways to respond to the expected patient boom.
“These models we know work. They save money and improve quality of life,” he said. “Two things are how to pay for them, and how to implement them in a system of care that already exists and is not motivated to work this way. To pay for the type of intervention, you need to take care of the new financial model. “
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