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CHICAGO – Too few people with signs of wasting or dementia are the subject of a routine medical check-up or are aware of the presence of a problem, according to a panel of 39; Alzheimer's disease experts who proposed new directions Sunday. Although mental decline may be an uncomfortable topic for patients and their physicians, the expert group says that family physicians should make a careful assessment when symptoms occur and share the same thing.
Patients and their family members should ask for an assessment if they are concerned that the symptoms are not normal aging – the difference between misplacing keys or putting them in the freezer or confusing them
"By the time you forget the keys, you're too far away to participate in your own care, we've probably lost a decade" that could have been Dr. Alireza Atri, a neurologist at the Banner Sun Health Research Institute in Arizona
It's not just memory that can suffer when mental decline begins, says Atri. their character and personality disappear, "sometimes years before dementia is diagnosed," he said.
About 50 million people worldwide suffer from dementia; Alzheimer's disease is the most common form of Alzheimer's disease. In the United States, nearly 6 million suffer from Alzheimer's and nearly 12 million suffer from mild cognitive impairment, common precursors.
In 2015, the Alzheimer's Association research using Medicare records suggested that only half of the people treated were suffering from Alzheimer's disease. "Doctors too often hear symptoms or memory complaints from patients or their spouses and say," You know, you I look good today., "so come back in six months, said James Hendrix, a scientist from the Alzheimer's Association who worked with the panel. During this time, the patient may end up hospitalized for problems such as forgetting to take a diabetes medicine because their mental deficiency has not been caught.
"We hear stories all the time from people taking years to get an accurate diagnosis.Silverberg, a psychologist who runs Alzheimer's programs at the National Institute on Aging, who does not have a doctor, does not know. had no role in the guidelines.
Medicare has recently started to cover mental assessments as part of the annual wellness visit, but doctors are not required she said that it's n & # 39; There was no indication of how to do this, and in some cases it may be as superficial as asking "how is your memory going?"
The committee was appointed by the Alzheimer's Association and included Primary Care Physicians, Aging Specialists, Nurses and a Psychiatrist The outline was published Sunday at the group's International Conference in Chicago, details to be published later this year. 9003] The guidelines do not recommend screening everyone. They describe what health workers should do if people describe disturbing symptoms. This includes: checking for risk factors that may contribute to dementia or other brain diseases, including family history, heart disease and head injuries; pen and pencil memory tests; imaging tests to detect small strokes or brain injuries that could cause memory problems.
Dr. Michael Sitorius, president of family medicine at the University of Nebraska Medical Center, said the treatment of mental decline adds to the challenge of caring for elderly, often frail patients
. "He's trying to cure people and Alzheimer's disease and dementia are not curable."
He said that he was giving mental tests to his older patients during their annual check-ups, but sometimes patients or their relatives do not want to hear the results. In these cases, Sitorius still addresses related issues, including depression, medication protection, nutrition, and the need to continue driving.
He stated that the new guidelines are a good reminder to family physicians to address these issues sooner.
A diagnosis should never be dismissed for fear of depressing the patient, says Atri.
"We strongly encourage full disclosure", including diagnosis, stage and prognosis. ", he said.
At the request of her daughter, Anne Hunt visited her family doctor in 2011 because of growing oblivion. Hunt, 81, who once ran a cooking school in Chicago, recalls having memory tests involving letters and numbers that his doctor had made him perform
"I thought," I'm a vegetable Hunt said, but the results of the tests were inconclusive, and there was no diagnosis.
"We did not do much," said Bruce Hunt, Anne's husband, five years later, when her behavior was clearly getting worse.It is repeating itself and forgetting where to put things.
She was diagnosed with Alzheimer's after a test of & dquo; Imaging that has shown brain changes often seen with the disease.Image tests are sometimes used with mental tests to diagnose the disease or rule out other conditions.
"There is no There is no pill to make it go away, so some people think that it's useless to ask u "No diagnosis," said Silverberg of the National Institute of Ageing. "Medications for Alzheimer's disease like Aricept and Namenda can relieve symptoms but do not cure.
Experts say other benefits include the opportunity to participate in experiments to test treatments, solve financial problems, find caregivers, make homes safer and use memory aids and calendars for to promote an independent life.
The Hunts joined support groups and a group of singers hoping that new things would help them cope. They were better prepared than some. Long before his diagnosis, they converted an old Chicago apartment building into two big homes so that they could grow old with the help of one of their daughters and family.
Anne Hunt said that she wanted to know the truth about her.
"Do not know, it's wonder why things happen to you and you do not understand them," she said. "I would prefer to know and ask someone to help me understand how I can control this to the best of my ability."
Associated Press Health & Science Department receives support from the Department of Health. scientific education of the Howard Hughes Medical Institute. The AP is solely responsible for all content.
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