This article is sponsored by the Academy for Continued Healthcare Learning, an independently owned and operated full-service medical education company that has been developing certified health care education for nearly twenty years.
With a special thanks to NAMI Chicago, the accompanying CME activity designed for clinicians in primary care is supported by educational grants from Lilly and Genentech, a member of the Roche Group.
Alzheimer’s disease has a devastating impact on patients, their families, and society as a whole. Patients suffer a loss of independence, reduced quality of life, and disability. Families caring for their loved ones with Alzheimer’s disease experience more physical and psychological ailments and financial difficulties. As significant as these burdens are, they will only increase as the number of patients increases. Estimates indicate that the number of patients with Alzheimer’s disease in the U.S. will increase from approximately 6 million in 2022 to approximately 12 million in 2050. Consequently, it is absolutely vital that patients, families, and clinicians take steps to better identify Alzheimer’s disease earlier so it can be treated earlier.
Unfortunately, studies have shown that up to 67 percent of patients who are screened for thinking and memory deficits in primary care and are found to have signs of impairments refuse further diagnostic testing. Why? There are a variety of reasons, including:
- A perceived lack of benefit of diagnosis, such as limited treatment options and no cure
- Difficulty in accepting a diagnosis of Alzheimer’s disease
- A perception that diagnosis would require a lot of expensive tests but may be inaccurate
- Stigma associated with Alzheimer’s disease
- Fear of losing independence
But do earlier diagnosis and intervention matter? Yes! A study from 2021 found that early medication use reduced the risk of patients requiring admission to 24-hour care facilities. In addition, recent practical recommendations from experts published in the Journal of Internal Medicine outlined the benefits of timely recognition and diagnosis of Alzheimer’s disease in primary care, including:
- Patient/family education and counseling
- Maximizing time available for medical and financial planning
- Early introduction of strategies and tools to maximize independence
- Early intervention for memory loss, mood and anxiety disorders, and psychosis
- Potential delay in admission to nursing homes
- Earlier opportunity to connect with support agencies
- Opportunity to participate in clinical trials of new medications
For families, there are specific benefits of an earlier diagnosis of Alzheimer’s disease, including:
- Reductions in anxiety and depression
- Time to adjust to changes in a patient’s function, mood, and personality
In fact, in a survey of family care providers, nearly 50 percent of respondents indicated that they would have preferred an earlier diagnosis of Alzheimer’s disease. In addition, family care providers who believed the diagnosis was delayed were more likely than others to report sadness, depression, and despair for years after the diagnosis.
What can clinicians do in primary care settings to move toward earlier diagnosis of Alzheimer’s disease?
- Increase understanding of early signs and symptoms of Alzheimer’s disease
- Conduct annual assessments of thinking and memory in all patients ≥65 years of age or, if such assessments are not practical, ask about signs and symptoms in patients with known risk factors for Alzheimer’s disease (e.g., family history, advanced age, and cardiovascular risk factors)
- Use objective tools to monitor thinking and memory
- Use easily available imaging methods (e.g., magnetic resonance imaging) if Alzheimer’s disease is suspected
- Consider using specific biomarker tests to confirm a diagnosis of Alzheimer’s disease
It is also important for clinicians to carefully consider how they communicate with patients and families. Family care providers indicate that better communication about a diagnosis of Alzheimer’s disease reduces sadness, depression, and despair and leads to greater acceptance and reassurance.
To better support clinicians in the primary care setting, the Academy for Continued Healthcare Learning (ACHL), in collaboration with Dr. Andrew E. Budson, developed an educational activity to model ways in which conversations between patients/families and clinicians can be improved to assist in the earlier diagnosis of Alzheimer’s disease.
Join us on Monday, February 13 at 7 p.m. Eastern on the KevinMD platform to hear Dr. Budson, along with two Alzheimer’s disease caregivers, Jess Rappé and Ellie Freedman, share their Alzheimer’s disease stories and insights.
Click here to access the activity and receive CME credit. Be sure to take this step toward improving the diagnosis of Alzheimer’s disease today!
Andrew E. Budson, MD, is s chief of cognitive behavioral neurology at the Veterans Affairs Boston Healthcare System, associate director at the Boston University Alzheimer’s Disease Research Center, professor of neurology at Boston University School of Medicine, and lecturer in neurology at Harvard Medical School.
Jess Rappé is the president of a design and marketing firm in Chicago. She is passionate about mental wellness and is a long-time volunteer and board member of the National Alliance on Mental Illness (NAMI) Chicago. Her journey with Alzheimer’s is through her experience as a primary caregiver for her mother, who has been living with the disease since diagnosis nearly four years ago.
Ellie Freedman is the owner of Wildwood Tavern in Niles, Illinois. Ellie’s father was diagnosed with Alzheimer’s disease in 2010, and she was the primary caregiver and medical liaison throughout her father’s illness.
Lisa Keckich is executive director and Natasha Mitchner is vice president, scientific services, Academy for Continued Healthcare Learning.