After Screening Positive for Dementia, Many Seniors Refuse Evaluation
the Psychiatry Advisor take:
The majority of adults aged 65 and older who had positive dementia screening results refused follow-up evaluation, according to a study published in Alzheimer’s & Dementia: Diagnosis, Assessment, & Disease Monitoring.
Individuals who lived alone were most likely to refuse follow-up assessment. Additionally, participants who had negative preconceptions of the stigma around dementia were also more likely to refuse diagnostic assessments, though it did not affect their willingness to undergo screening.
Participants who did agree to subsequent assessment were more likely to agree with positive statements about other types of screening like colonoscopy.
The study included approximately 500 older adults without previous diagnosis of dementia. Age, gender, and race were not associated with subsequent diagnostic assessment after a positive screening.
"The findings from our study are important given the low rates of detection of dementia and the high percentage of older adults with dementia who never receive a cognitive evaluation," researcher Nicole Fowler, PhD, of the Indiana University Center for Aging Research, said in a statement. "Early intervention and education of patients and their caregivers on dementia and dementia screening could increase the number of patients seeking diagnostic assessment and inform efforts that address the perceived stigmas associated with dementia screening.”
Although dementia is not treatable, identifying the condition early can help patients better manage their symptoms and prepare their families for the future. The researchers hope that their results will provide insight to the value of population-based dementia screening.
Older adults who screen positive for dementia often refuse diagnostic evaluation, partly because of stigma surrounding the condition.
Two thirds of individuals 65 and older who screened positive for cognitive impairment refused subsequent evaluation according to the first study of its kind to examine older adults' willingness to undergo diagnostic assessment. The Indiana University Center for Aging Research, Regenstrief Institute and Eskenazi Health study of approximately 500 older adults found that individuals living alone were the least likely to agree to diagnostic assessment following a positive screening test for dementia.
Screening is designed to detect if a problem exists. Diagnostic assessment provides a diagnosis based on the best available tests.
"Traits of Patients Who Screen Positive for Dementia and Refuse Diagnostic Assessment" is published in the June issue of Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, an open access, peer-reviewed journal from the Alzheimer's Association.
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