Taking a Look at the Cognitive Assessment Disconnect

In the time that it takes to read the first few paragraphs of this column, someone in the United States will develop Alzheimer’s disease. One person in the U.S. develops the illness every 65 seconds, according to a 2019 report.

The Alzheimer’s Association indicates that just over half of those aged 65 and older who responded to a survey noticed changes in their cognitive abilities. However, only 40 percent of this group have discussed their experience with a healthcare professional, and just 15 percent initiated a conversation with their doctor about their concerns.

The study referred to this cognitive assessment gap as a “disconnect.” That seems to be a spot-on definition.

Lack of assessment

During a typical medical appointment, when a patient describes symptoms to their doctor, they will be assessed and tests will be ordered, with the aim of finding a diagnosis. That is unless the symptoms are cognitive. Most patients fail to report cognitive slip-ups, and few doctors voluntarily evaluate cognitive ability — even though 94 percent of primary care physicians and more than 80 percent of seniors believe that checking for cognitive impairment is important. As mentioned above, there’s a disconnect.

Only 16 percent of seniors receive regular assessments for thinking and memory issues, according to the “2019 Alzheimer’s Disease Facts and Figures“ report. Additionally, primary care physicians say they assess 50 percent of their senior patients on average.

These facts and figures apply to my mother’s experience. Being cognizant about her health, she kept up with annual doctor’s visits. Our family noticed her memory was slipping. I suspect that our mother also noted small changes. However, to my knowledge, she didn’t bring up her concerns with her doctor until my father broached the topic. Her doctor then asked her a few questions and concluded that her memory loss was a normal aspect of aging. My mother bought it because she trusted her physician. We did not.

What is cognitive assessment?

A cognitive assessment is similar to other targeted health evaluations. The doctor will take a health history and ask about cognitive concerns. The patient might be asked to complete a written or verbal test, and be referred to a neurologist for further examination.

Unfortunately, 57 percent of physicians cite patient resistance as a reason that they don’t always provide brief cognitive assessments. My mother was part of another larger statistic — 68 percent of doctors choose not to carry out a cognitive evaluation of senior patients due to a lack of symptoms or complaints, which of course hinders a timely diagnosis.

Who’s to blame?

Medical doctors take an oath to “do no harm,” but we can’t entirely lay the blame on them for failing to diagnose Alzheimer’s disease or provide a qualified assessment. Some physicians lack the necessary tools to provide a cognitive assessment, or simply don’t know how to move forward if they suspect their patient has a memory disorder.

Most doctors are genuinely concerned for their patients and don’t intentionally harm them. But regardless of where the fault lies, with a patient unwilling to discuss memory issues or a physician lacking the resources to diagnose them, we know that a delay in diagnosis will cause harm.

Vigilant caregivers can help to guide their patients and loved ones to the right doctor for an accurate diagnosis.

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Note: Alzheimer’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Alzheimer’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Alzheimer’s Disease.