The National Institute on Aging (NIA) recently promoted earlier detection of dementia by publishing a short cognitive assessment guide aimed at primary care physicians.

The guide is an important enough document to get a plug on the federal Advisory Council on Alzheimer’s Research website.

For long-term care (LTC) planners, and for other financial services professionals who work with clients over the age of 40, looking at the guide could serve several purposes.

The guide might give you ideas about how to identify clients in need of extra attention.

See also: In California, all annuity producers are crooks

The guide might also give you ideas about the notes primary care physicians are putting in your clients’ and prospects’ medical records, and what the underwriters reviewing applications for long-term care insurance (LTCI) and other health-related products are expecting to see.

For a rundown of five brain health assessment tips from the guide, read on. 

Tree climbing toward clouds

1. Patients may be right to be worried.

NIA experts recommend providing cognitive impairment screening whenever people express concerns about changes in their memory or thinking; when family members express concerns; or when the primary care providers themselves notice changes in a patient’s memory, or thinking.

See also: Study: Alzheimer’s test detects disease decade ahead of onset 

Diabetes testing

2. Doctors should think about matters that might not seem to be directly related to cognitive impairment.

The NIA experts recommend that primary care doctors think about impairment if a patient is age 80 or older, or if the patient has had trouble with managing money or medications.

But the NIA is telling doctors that other risk factors possibly indicating a need for dementia screening include having a low education level, a history of stroke or depression, or a history of type 2 diabetes.

See also: Study ties higher blood sugar to dementia risk 

A clock

3. More in-depth screening may start with the clock.

The NIA has developed an entire searchable database of instruments for detecting cognitive impairment.

The NIA suggests that providers start with a quick, simple tool, such as the Mini-Cog test, which is posted on the Alzheimer’s Association website.

The provider giving that test first reads several words to the patient, then has the patient draw a clock. Once the patient finishes drawing the clock, the provider asks the patients to try to remember the three words.

If the patient has trouble drawing the clock, or forgets all of the words, that might be a sign of a need for comprehensive dementia screening.

See also: Alzheimer’s panel: Screen caregivers, too 

Mirror

4. Doctors could supplement “How are you doing?” with a standardized self-assessment questionnaire.

The NIA mentions the AD8 questionnaire, which was developed by researchers at the Alzheimer’s Disease Research Center at Washington University in St. Louis.

A provider can get a quick dementia risk score by asking about possible changes in eight areas, such as trouble with remembering appointments.

See also: 4 things you should know: LTCI paramedical exams 

Dark water

5. Doctors could throw in a depression assessment. 

The NIA suggests a collection of 15-question and 30-question geriatric mood assessment questionnaires that are posted on the website for Stanford University’s Aging Clinical Research Center.

The center has posted versions in many different languages, ranging from Arabic, to Latvian, to Yiddish.

The questionnaire includes questions such as, “Do you often get bored?” and “Do you often feel helpless?”

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