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When Patients Are Close-Lipped About Memory Problems
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JAMA
March 8, 2016
Physicians can’t count on patients to raise concerns about memory loss at routine checkups, even when memory lapses infringe on daily living.
Only 25.2% of adults 45 years or older with subjective memory complaints reported discussing them with a health care professional at a recent routine visit, according to the 2011 Behavioral Risk Factor Surveillance System. Too few discussions about memory issues at health care visits create lost opportunities either to find treatable conditions unrelated to dementia or to diagnose dementia early and help patients access community services, receive therapy or enroll in a clinical trial, and make decisions about future health care, according to the study’s author (Adams M. Prev Chronic Dis. 2016;13:E15).
Among the 10 276 respondents in 21 states who reported subjective memory complaints, those with more intrusive cognitive decline in daily life were more willing to talk about their problem with a health care professional. About half of patients opened up about their concerns if confusion or memory loss always interfered with household chores or work.
People with depression (33.2%) or disability (29.2%) were more likely to bring up memory problems, perhaps because they’re more comfortable discussing problems with a health care professional or because memory issues make their other health problems more acute. Advancing age, however, was associated with a reluctance to mention cognitive problems; only 14.4% of those 85 years or older discussed memory complaints compared with 27.1% of those aged 45 to 54 years.
Talking about memory loss led to treatment, according to 41.8% of respondents. However, the finding is likely an underestimate, the author wrote. Only respondents who said they had a discussion with a health care provider were asked about treatment, and some may not know that therapy they receive for other health conditions also addresses memory problems.
Although the Affordable Care Act stipulates that Medicare beneficiaries get an annual cognitive assessment, patients younger than 65 years can also benefit from discussions about memory problems and cognitive decline, the author wrote. Public health officials can help by raising awareness of early detection of dementia and urging people to talk about their memory loss.