Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Look to the future: Preparing for baby boomer dementia epidemic

24.06.2005


How can the U.S. health-care system and more specifically, primary care doctors - the physicians from whom older adults receive most of their care - prepare for the huge wave of dementia patients expected to engulf us in 2010, the year the baby boomers begin to reach 65?



Researchers from the Indiana University School of Medicine, the Regenstrief Institute, Inc. and the Indiana University Center for Aging Research begin to answer this difficult question in a study published in the July issue of the Journal of General Internal Medicine, now available online.

The researchers conducted a dementia screening program on 3,340 older adults attending primary care clinics. They used the CSID, a highly regarded, culturally sensitive screening test. Screening results indicated that 434 were possibly or potentially suffering from dementia.


"Dementia is common and unrecognized in primary care," said Malaz Boustani, M.D., M.P.H., the first author of the study and an assistant professor of medicine. "Since screening instruments alone have insufficient specificity to establish a valid diagnosis of dementia, all 434 were invited back for a diagnostic assessment."

Unfortunately 50 percent of those in the study who screened positive for dementia did not return to evaluate their screening results. Such evaluation would have ruled-in or ruled-out the presence of dementia.

"That’s similar to half of female patients whose mammograms show possible cancers not returning for biopsies to determine whether they have a malignancy. Screening tools require confirmation and the primary care doctor who screens must be prepared to follow up with confirmatory testing," said Dr. Boustani.

Of the 227 who did return for diagnostic assessment, only one-half received a diagnosis of dementia. Slightly less than one-third had mild cognitive impairment not severe enough to cause dementia. One-fifth did not have any type of cognitive problem.

Early diagnosis of dementia may allow individuals to plan for their future while they still have the mental capacity to make important care and end-of-life decisions. There are medications which may improve symptoms of dementia in some people.

The negative impact of unrecognized dementia on the management of other medical conditions is significant, noted Dr. Boustani. "Physicians typically are treating older adults for multiple chronic diseases such as hypertension, diabetes and high cholesterol and unless the patient presents with symptoms of dementia, the physician assumes the patient has the mental capacity to take medications appropriately and follow other directions. If we don’t detect and help older adults with asymptomatic dementia, they potentially will not benefit from the medical management of their other health problems and thus, become big users of health-care dollars."

Additionally, dementia puts both the patient and others at risk. Individuals with advanced dementia are better off not living alone or driving.

The cost to society for care of individuals with unrecognized dementia is substantial. The cost of screening and, if indicated, diagnosing each older adult who participated in the study was $130. If the total cost of the program is divided by the number of cases of dementia detected during the study, each confirmed dementia case would cost $4,000.

The authors found the disparity between the number of patients screened and those that returned for diagnostic assessment disturbing.

"Our team thinks this may reflect the societal stigma of dementia," said Dr. Boustani. "Patients may be scared that they will be discriminated against in the workplace or that they will be placed in a nursing home against their will."

Co-authors of the study are Christopher Callahan, M.D.; Frederick Unverzagt, Ph.D.; Mary Guerriero Austrom, Ph.D.; Anthony Perkins, M.S.; Bridget Fultz, M.A.; Siu Hui, Ph.D.; and Hugh Hendrie, MB, ChB, DSc. The study was funded by a grant from the Agency for Healthcare Research and Quality.

The IU and Regenstrief researchers currently are conducting a collaborative study, the PRISM - US vs. UK, with British researchers from the University of Kent at Canterbury to learn whether such a stigma exists and, if so, its variation between the U.S. and the United Kingdom health-care systems.

Cindy Fox Aisen | EurekAlert!
Further information:
http://www.iupui.edu

More articles from Health and Medicine:

nachricht Millions through license revenues
27.04.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht New High-Performance Center Translational Medical Engineering
26.04.2017 | Fraunhofer ITEM

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Fighting drug resistant tuberculosis – InfectoGnostics meets MYCO-NET² partners in Peru

28.04.2017 | Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

 
Latest News

Wireless power can drive tiny electronic devices in the GI tract

28.04.2017 | Medical Engineering

Ice cave in Transylvania yields window into region's past

28.04.2017 | Earth Sciences

Nose2Brain – Better Therapy for Multiple Sclerosis

28.04.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>