SPRINGFIELD, Mass., Nov. 18, 2011 /PRNewswire/ -- Mitchell Clionsky, Ph.D. and Emily Clionsky, M.D. of CNS-Neuro, announced new data supporting the use of screening tests to identify cognitive loss in older Americans. Their study asked two hundred elderly patients and their families to rate how well they think and remember. They found that the patients' answers had no relationship to their tested cognitive ability, that the relatives were minimally better, and that doctors should measure cognition rather than asking about it during the Annual Wellness Visit. These findings, published in the November 2011 Journal of Family Practice (http://www.jfponline.com/pages.asp?id=10018) may help doctors decide which of their patients need treatment for memory loss. Memory Orientation Screening Test (MOST™) gives doctors accurate tools for Annual Wellness Visit.
The authors, a neuropsychologist and an internist/psychiatrist, asked patients and their loved ones to rate their abilities to pay attention, remember, start new projects, make judgments and care for themselves. They found that patients were unable to accurately determine if they were normal or not. They also discovered that their loved ones, who accompanied them to a cognitive testing appointment, were scarcely better. By contrast, their 5-minute office test, the Memory Orientation Screening Test (MOST™) accurately identified these problems and was significantly better at this than a longer test most often used by doctors, the Folstein Mini-Mental State Exam.
This finding is particularly important since, in January 2011, Medicare has encouraged all seniors to have an Annual Wellness Visit. The AWV is a no-copayment office visit in which doctors are asked to identify cognitive impairment, measure depression, take the patient's blood pressure, calculate their body mass index, document all current illnesses and list all current medications to formulate a preventive health plan for the next year. Medicare had not instructed doctors how to identify cognitive problems, instead relying on their office observations and reports of patients and family members. But, the findings of this study suggest that such impressionistic data is misleading. Patients deny or overrate their thinking. They tell doctors that they remember all that they need to remember and they give excuses for their memory failures. If doctors take these reports at face value, they will fail to make a diagnosis of dementia in its early stages and will not start memory-stabilizing medications when they are the most likely to be beneficial. In an era when Alzheimer's disease and other dementias affect almost 6 million seniors and is increasing every year, this reliance on inaccurate data leads to a failure to diagnose and treat this important condition.
Dr.