55% of people with dementia have never seen a doctor, shows study

The majority of people with dementia have never seen a doctor about their memory and thinking problems, according to a new study published in the November 26, 2014, online issue of Neurology®, the medical journal of the American Academy of Neurology.

In the study, 55 percent of the people with dementia had never had an evaluation of their thinking and memory skills with a doctor.

"These results suggest that approximately 1.8 million Americans over the age of 70 with dementia have never had an evaluation of their cognitive abilities," said study author Vikas Kotagal, MD, MS, of the University of Michigan Health System in Ann Arbor. "Yet early evaluation and identification of people with dementia may help them receive care earlier."

Kotagal said early diagnosis can help families make plans for care, help with day-to-day tasks and watch for problems that can occur. In some instances, these interventions could substantially improve the person's quality of life.

The study was part of a larger, nationally representative, community-based study called the Health and Retirement Study. From that study, 845 people age 70 and older were evaluated for dementia. For each participant, a spouse, child or other person who knew the person well was asked whether the participant had ever seen a doctor for any concerns about memory or thinking.

A total of 297 of the participants met the criteria for dementia. Of those, 45 percent had seen a doctor about their memory problems, compared to 5 percent of those with memory and thinking problems that did not meet the criteria for dementia, and 1 percent of those with normal memory and thinking skills.

The researchers found that people who were married were more than twice as likely to have a screening as people who were not married. "It's possible that spouses feel more comfortable than children raising concerns with their spouse or a health care provider," said Kotagal. "Another possibility could be that unmarried elderly people may be more reluctant to share their concerns with their doctor if they are worried about the impact it could have on their independence."

Other demographic factors did not have an effect on whether or not people had screenings, including race, socioeconomic status, the number of children and whether children lived close to the parents. "Our results show that the number and proximity of children is no substitute for having a spouse as a caregiver when it comes to seeking medical care for memory problems for a loved one," Kotagal said.

People with more severe cognitive impairment were also more likely to have seen a doctor for an evaluation than people with less severe memory and thinking problems.