New Tool Improves Dementia Detection in Diverse Primary Care Settings
While over 6 million older adults in the U.S. live with dementia, a recent study suggests many cases go undiagnosed, particularly among Black and Hispanic Americans in busy primary care settings.
Early detection of dementia or its precursor, mild cognitive impairment (MCI), is crucial for treatment and ensuring safety. Standard tests can be lengthy, expensive, and culturally biased, limiting their effectiveness in diverse populations.
Culturally Neutral Tool Shows Promise
Researchers at Albert Einstein College of Medicine led by Dr. Joe Verghese developed a culturally unbiased cognitive assessment tool called 5-Cog to address this gap. Designed for older adults with memory concerns, 5-Cog consists of three brief tests: memory recall, coordination, and symbol-matching. The test takes about five minutes and can be administered by non-medical personnel.
Study Highlights Positive Outcomes
A recent National Institutes of Health (NIH)-funded study published in Nature Medicine on June 4, 2024, tested 5-Cog in over 1,200 older adults from a Bronx, New York primary care clinic. Nearly all participants were Black, Hispanic, or Latino, and a significant portion had not graduated high school.
The study randomly assigned participants to receive either 5-Cog or a control test before a primary care visit.
Improved Dementia Care Rates
The results were promising. Nearly 20% of those who took the 5-Cog test received improved overall dementia care within 90 days, compared to under 7% in the control group. This included new dementia or mild cognitive impairment diagnoses, further assessments, and specialist referrals. There were no significant differences in hospitalizations or emergency department visits between groups.
Future Directions and Importance
Dr. Verghese says the goal is to get more people properly diagnosed and treated.
We hope these findings will encourage changes in primary care to ensure more older adults with cognitive decline get diagnosed and treated.
Researchers are conducting further studies to assess 5-Cog's effectiveness in identifying early cognitive changes in those without reported concerns and in different populations.
Air-Pollution and Dementia
A recent study by the NIH found that long-term exposure to certain types of air pollution may be linked to an increased risk of dementia. Often, many Black and Hispanic Americans may live in more densely populated urban areas with more air pollution problems.
Charles Bernick, MD, MPH, a Cleveland Clinic neurologist, was not involved in the study but said researchers examined nine emission sources.
I think the findings are helpful and also support what people have found previously, that there seems to be a relationship between exposure to higher levels of fine particulate matter and dementia.
Some pollution sources studied included agriculture, wildfires, road traffic, and coal combustion for energy production.
Researchers reviewed data from nearly 28,000 adults aged 50 and older over a 10-year span. Ultimately, they found that 15% of the participants developed dementia.
Additionally, the study revealed that agriculture and open fires had the strongest associations with air pollution and dementia.
So, how exactly does air pollution play a role with dementia?
There's several potential ways air pollution could affect the brain. One is through just inflammation that it causes in the lungs, in the body that may also enter the brain.
Dr. Bernick also notes that the toxic properties of air pollution itself could directly enter the brain. But, at the moment, they don't know.
Long-Term Senior Healthcare
Those with dementia ultimately will need long-term care and supervision. Dementia is one of many reasons people require long-term senior healthcare.
Families are usually unable to provide the quality caregiving that someone desires, and this can place a tremendous physical and emotional burden on loved ones.
Quality long-term care services can be found. The LTC NEWS Caregiver Directory can help you find options from over 80,000 listings. With a few clicks, you can search and compare caregivers, senior communities, and long-term care facilities -- all free -- making finding long-term care for a loved one easier.
The cost of care services varies depending on the type and level of care and the location. Whether you are looking for assisted living facilities in Lexington, KY, or memory care in Bakersfield, CA, you can see the current cost of care services where you live by using the LTC NEWS Cost of Care Calculator.
Then, you can find the caregivers or facilities where you live and compare long-term care services and costs with the directory.
Paying for Long-Term Care
There is a question on how to pay for long-term care services. Many Americans believe long-term care services, including dementia care, are covered by health insurance or Medicare. This is not the case, as health insurance and Medicare only pay for short-term skilled care.
Medicaid is relied on by those with limited financial resources, but the care recipient must use Medicaid-approved long-term care facilities and providers.
Long-Term Care Insurance will pay for comprehensive long-term elder support services, including in-home care, adult day care centers, assisted living, memory care, and nursing homes. The problem is you cannot purchase an LTC policy once your health has declined.
There are various types of Long-Term Care Insurance policies to choose from, but all LTC policies will cover dementia care.
Long-Term Care Insurance is usually acquired in your 40s or 50s as part of retirement planning. However, if someone has relatively good health, affordable options are available for someone in their 60s and older.
Experts suggest working with an experienced Long-Term Care Insurance specialist who represents the top-rated insurance companies. Since underwriting rules and LTC insurance premiums vary dramatically, an LTC Insurance specialist will help you navigate the available options to find affordable options. The specialist will provide accurate quotes from all the leading insurance brands so you can make the best planning decision.
America is Aging – So are You
Demographically, America is aging, and age is the number one risk factor for dementia or Alzheimer's. Planning ahead can help you and your family manage the costs and burdens associated with aging. For a loved one already experiencing a decline due to chronic health issues, mobility difficulties, dementia, or frailty, accessing quality long-term care services can significantly improve their quality of life.
Dementia and the challenges of aging aren't going away anytime soon. Preparing for these changes and being proactive about your health can help ensure you have access to quality care, easing the burden on your loved ones.