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Most adults not reporting memory problems during routine checkups

Routine checkups could be a missed opportunity for discussions between primary care physicians and their patients regarding memory loss that may lead to diagnosis and treatment, and those younger than 65 years may benefit from cognitive assessment, according to data published in Preventing Chronic Disease.

“Although the U.S. Preventive Services Task Force does not recommend routine screening for dementia, which is often first manifested in memory problems, early diagnosis is important for numerous reasons,” Mary Adams, MS MPH, of On Target Health Data, in West Suffield, Connecticut, wrote. “These include ruling out treatable causes of memory problems not related to dementia, providing a better chance for treatment to be effective, offering enrollment in clinical trials, and discussing community services.”

To determine how many adults with subjective memory complaints (SMCs) discussed those problems with a health care professional, the factors associated with that discussion and the proportion of patients who received treatment, Adams analyzed publicly available data in the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS collects data from noninstitutionalized adults aged 18 and older through monthly random-digit-dial telephone surveys. Adams examined the 2011 survey, which collected data from respondents in 21 states: Arkansas, California, Florida, Hawaii, Iowa, Illinois, Louisiana, Maryland, Michigan, North Carolina, Nebraska, New Hampshire, New York, Oklahoma, South Carolina, Tennessee, Texas, Utah, Washington, Wisconsin and West Virginia.

The data were limited to 10,276 respondents aged 45 years or older who used landlines and reported in the survey that they had experienced SMCs. Adams examined responses to questions regarding the effects of their memory loss, whether they had discussed the issue with a health care professional, and if they had received treatment for the problem. Odds ratios adjusted for demographic and health-related measures were computed for discussing SMCs with a health care professional.

According to Adams, 22.9% of respondents aged 45 years or older reporting SMCs had discussed their memory problems with a health care professional. Among those who said they had recently undergone a routine checkup, that rate was 25.2%. The largest odds ratio for talking with a clinician were found among respondents who said their memory issues had “always” caused them to give up household chores (OR = 3.02; 95% CI, 1.81-5.05) or “always” interfered with work (OR = 2.98; 95% CI, 1.89-4.7), and those who were college graduates (OR = 2.42; 95% CI, 1.68-3.48). In addition, increased age reduced the likelihood of discussing SMCs with a physician. Of those who had discussed their memory issues, 41.8% received treatment.

“These results, based only on adults reporting SMCs, highlight the need for cognitive assessment requited in the Affordable Care Act for Medicare recipients and also suggest the need and potential benefits of cognitive assessment among adults younger than 65,” Adams wrote. “Although memory problems could be discussed during any routine checkup, these results show that few adults reporting SMCs, even those with memory problems causing functional difficulties, are availing themselves of that opportunity.” – by Jason Laday

Disclosure: The author reports no relevant financial disclosures.