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Source: DGNews  |  Posted 22 weeks ago

AAN Recommends People Aged ≥65 Be Screened Yearly for Memory Problems

The American Academy of Neurology (AAN) is recommending that physicians measure how frequently they complete annual assessments of people aged ≥65 years for thinking and memory problems.

Published in Neurology, this metric for yearly cognitive screening tests is part of an AAN quality measurement set that aims to help physicians and practices understand how often healthcare services are consistent with current best practices and are based on existing AAN guideline recommendations.

“Since thinking skills are the most sensitive indicator of brain function and they can be tested cost-effectively, this creates an enormous opportunity to improve neurologic care,” said Norman L. Foster, MD, University of Utah, Salt Lake City, Utah.

“The American Academy of Neurology is recommending the measurement of annual cognitive screenings for everyone aged ≥65 [years] because age itself is a significant risk factor for cognitive decline and mild cognitive impairment (MCI) is increasingly prevalent with older age,” he continued. “The measure complements past American Academy of Neurology quality measures released for Parkinson’s disease, multiple sclerosis, and stroke, and allows for a doctor to meet the measure with a recommended periodic 3-minute cognitive test.”

According to the 2018 AAN guidelines on MCI, nearly 7% of people in their early 60s worldwide have MCI, while 38% of people aged ≥85 years have it.

The new AAN quality measurement set recommends that doctors measure how often they conduct annual screenings to improve the recognition of MCI and allow for earlier intervention.

The measurement set also states that documenting MCI in a person’s medical record can be invaluable in alerting other physicians and medical staff so that the best care is provided to that patient.

Early diagnosis can help identify forms of MCI that may be reversible, including those caused by sleep problems, depression, or medications, and lead to treatments that can improve a person’s quality of life such as correcting hearing loss and avoiding social isolation.

When MCI is not reversible and could develop into more severe forms of dementia like Alzheimer’s disease, the quality measurement set recommends measuring how frequently people are given information about their condition as early as possible, so they can take steps to avoid exploitation, plan for their care, and monitor their condition.

It is also important not to forget about family and caregivers. The measurement set asks doctors to identify care partners to help describe symptoms. Doctors should quantify involvement with family and caregivers and provide them with information so that they can also receive support and get access to services.

“We cannot expect people to report their own memory and thinking problems because they may not recognise that they are having problems or they may not share them with their doctors,” concluded Dr. Foster. “Annual assessments will not only help identify MCI early, it will also help physicians more closely monitor possible worsening of the condition.”

Reference: https://n.neurology.org/content/early/2019/09/18/WNL.0000000000008259

SOURCE: American Academy of Neurology

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