Millions Of Americans Have Cognitive Decline And Don't Know It

Arthur T Knackerbracket has processed the following story:

Millions of Americans and their doctors are in the dark when it comes to early cognitive decline, according to new research from the University of Southern California. A study out this week suggests that most general physicians vastly under-diagnose mild cognitive impairment among their patients, following another recent study from the same authors which found that millions of Medicare patients with the condition slip through the cracks. The researchers say this diagnostic gap is worrying, given the importance of recognizing and treating mild cognitive impairment before it becomes more serious.

It's well established that mild cognitive impairment is under-diagnosed in older people, but the researchers say theirs is some of the first work to quantify the current size of the problem.

It's a very different conversation to have when we can point to these numbers," senior study author Soeren Mattke, director of the Brain Health Observatory at USC's Center for Economic and Social Research, told Gizmodo over the phone.

In the latest study, published Tuesday in The Journal of Prevention of Alzheimer's Disease, the team looked at Medicare administrative data collected from over 200,000 primary care clinicians and 50,000 practices between 2017 to 2019. They found that doctors and practices failed to diagnose about 92% of expected mild cognitive impairment cases on average; they also estimated that only 0.1% of physicians accurately diagnosed it as often as they should, based on expected rates.

In the previous paper, published this July in the journal Alzheimer's Research & Therapy, the authors examined the medical records of over 40 million Americans over 65 enrolled in Medicare and Medicare Advantage plans between 2015 to 2019.

Based on other research, about 8 million of these Americans should have mild cognitive impairment, defined as noticeable memory loss or cognitive decline that doesn't yet impede a person's everyday activities. But although the rate did slightly improve over time, only a small portion of Medicare patients actually received a mild cognitive impairment diagnosis during the study period, amounting to about 8% of expected cases.

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