Staying Fit
Think back to your last yearly wellness visit. Your doctor probably checked to see how your heart is holding up — but what about your brain?
Quick tests that screen for thinking and memory problems should be part of this annual appointment, which is covered by Medicare, but research shows that not everybody is getting evaluated. A 2020 study published in the journal Health Affairs found that only about a quarter of surveyed Medicare beneficiaries received a so-called cognitive assessment at their annual wellness visit. And a separate report from the Alzheimer’s Association found that fewer than half of primary care physicians (47 percent) say assessing patients 65 and older for cognitive impairment is part of their standard protocol.
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That said, 6 in 10 adults say they would be convinced to have their cognition evaluated if their doctor recommended it, AARP research found. And more than half of adults (54 percent) surveyed by AARP are in favor of having at least a baseline screening for dementia.
“Even if you aren’t concerned about having dementia now, schedule your Medicare annual wellness visit and ask for your cognitive screening,” says Sarah Lenz Lock, AARP senior vice president for policy and brain health and Global Council on Brain Health executive director. “That will give you a baseline so that you can notice changes over time and you can discuss ways to reduce risks to your brain health in the future.”
Here are four reasons why you should inquire about an assessment at your next visit.
1. The no-frills tests are quick
Evaluating a patient’s cognition — how one thinks, learns, understands, remembers, reasons and makes decisions — may sound complicated, but screenings done in the doctor’s office don’t require high-tech tools and take only a few minutes to complete.
There isn’t one standard test that’s given, says Sarah Kremen, M.D., associate professor of neurology and director of the Neurobehavior Program at Cedars Sinai Medical Center in Los Angeles. Rather, your physician might choose one (or a few) from several that are commonly used to check various brain functions.
A health care provider might recite three words and then ask the patient to repeat them back to gauge attention and short-term learning. A few minutes later, the patient may be asked to recall those words again.
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Another common test during a routine assessment is to have the patient draw the face of a clock and even draw the hands to a specific time. This task requires several skills, from abstract thinking to visual construction, Kremen explains, but overall it shows how well a person can organize and execute a plan.
A simple math problem or question on current events may make its way into the screening. The screening could be even more informal: The health care provider may simply observe the patient or talk to their spouse or caregiver about changes in day-to-day abilities.
These tests don’t provide a definitive diagnosis, but they could signal that a more thorough evaluation is necessary. “If and when your provider has any concerns, Medicare covers a separate visit to more thoroughly assess your cognitive function and develop a care plan,” Lock says.
