Screening over-70s for memory issues

Screening over-70s for memory issues

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An international panel has recommended that people over 70 be tested each year for problems with memory and reasoning.

They claim that the goal is to detect treatable disease, to provide lifestyle guidance to slow cognitive impairment, to identify patients who may be struggling to understand their doctor’s instructions, and to allow patients and families time to prepare if they are at high risk of developing dementia.

Our medical system already has tests in place to assess memory and reasoning, but I wonder whether these tests are being used appropriately. Are doctors hesitant in suggesting these tests? If there’s a problem, what next? Is there a pill that can intervene in this memory loss process, and restore some quality of life?

And there lies the problem.

History shows that generalised screenings create a new industry. We see them all the time. National prostate screening of years ago caused untold concern and unnecessary surgery, and was quickly stopped when the process was out of control.

My fear is that this will happen again.

Quite frankly, all governments have been very slow to recognise the fact that as Australiana grow older, their health requirements change dramatically. Unlike progressive European communities like Finland, we don’t have adequate facilities to cope with all the folks with dementia-related illnesses. Governments won’t commit the funds, and don’t have the long-term vision, to support the community expectations associated with dementia.

We know that many causes of cognitive impairment can be reversed or slowed when treated early. These include depression, hypothyroidism, sleep apnoea, and polypharmacy for multiple chronic conditions.

We also know the benefits of the Mediterranean diet for patients with early cognitive issues: its emphasis on fruits, vegetables, fish, olive oil and nuts. There is also good evidence for physical exercise, in particular resistance training and tai chi, intellectual activity, dance and playing a musical instrument, in helping to slow mental decline in people over 70.

Unfortunately, the solution here in Australia is to prescribe a drug from a particular group, knowing full well, that this is a short-term, band-aid remedy.

We have important role to play in advising our older patients on the options available to them, to help reduce their risk of memory and cognitive functional decline.

We have to slow down, and listen to their concerns, and start showing that we are the health destination where our leaders claim the solutions to wellness lie.

Or do they?

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