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If you had a crystal ball that would give you a glimpse into the future, would you use it?
Screening for cognitive health as you get older is just that: a glimpse into what the future might hold for you. The screening uses a variety of questions and simple tests to determine a score; that score will let your doctor know if you need to undergo further testing.
Mild cognitive impairment affects up to 22% of those over the age of 65, according to Columbia University. But unfortunately, many people who have early cognitive changes are unaware that they have a problem. That’s because the signs can be very subtle and transient at first. They are so subtle, in fact, that some might easily deny what they are experiencing or chalk it up to something else, like not getting enough sleep.
The brain goes through some natural decline with age. A screening test will let you know if the little changes you’ve noticed in your day-to-day life are simply the normal signs of aging or if they indicate something more serious. Let’s look at what seniors need to know about cognitive screenings.
Changes in the Aging Brain
Your brain begins to shrink as early as your thirties. All parts of the brain shrink, including the hippocampus, which is where learning and memory reside. In addition to shrinking, the nerve cells in your brain slowly lose their effectiveness, making it tough to send signals between them.
As the blood vessels stiffen with age, blood flow decreases, including blood flow to the brain. And finally, inflammation slowly increases with age. Inflammation is the culprit in a multitude of problems for the brain and body.
These changes in the aging brain are why seniors and elderly adults might find themselves becoming increasingly forgetful with minor things, like remembering names or forgetting where they put the car keys. These are normal parts of aging.
But sometimes the changes will be more profound and are not a normal part of aging. For some, the brain will gradually build up toxic clumps of proteins. These proteins, called amyloid, build up into plaques. These plaques allow another protein, known as tau, to attack the brain. Tau will kill neurons and lead to memory loss that is much more serious than what you get with normal aging.
This type of memory loss is the harbinger of a diagnosis of dementia, Alzheimer’s, or other types of cognitive impairment.
Since the changes in the brain can occur for many years before you begin to see symptoms, getting screened for cognitive impairment can help ensure that you get the prompt treatment you need to preserve as much of your memory, concentration, and other brain functions as you possibly can.
Another way to take care of your brain and overall health is by using a medical alert pendant or bracelet. Why does this matter to cognitive function? If you suffer a fall, especially one in which you hit your head, getting help right away can make a big difference. Delayed medical care is often linked to bad outcomes; eliminate delay by pressing the button to get help in moments.
Why Should Seniors Get a Cognitive Screening?
You might wonder if knowing is better than not knowing when it comes to your cognitive health. What if a screening shows that you are dealing with a cognitive problem? What if you can’t do anything about it? While that is a possibility, any cognitive decline detected by the test could be the result of nutritional deficiencies, the side effects of certain medications, or an underlying condition that can be treated.
In addition, if declines in cognitive ability are found, the results give you an opportunity to work with your doctor to create a treatment plan that will slow the progression.
A cognitive screening is an assessment, usually in the form of a questionnaire, that focuses on a person’s abilities in thinking, problem solving, language, and related functions. It’s the first step in a potential diagnosis, as a low score on cognitive screening leads to further testing.
Those who are on Medicare can have a basic cognitive screening included in their annual wellness visit for no charge at all. Getting screened every year after the age of 65 is a good idea, but you can request a screening earlier than that if you are concerned about your memory or thinking abilities.
Unfortunately, according to Health Affairs, only about half of all eligible seniors had an annual wellness check, and only a third of those reported a cognitive assessment as part of their exam.1
Remember that basic cognitive screenings can be done by a primary care physician; you don’t have to visit a specialist. It’s worth taking the time for an annual visit, and while you are there, ask for the cognitive screening, as many doctors won’t offer it automatically unless you are already showing symptoms of dementia.
What Is a Cognitive Screening Like?
The test typically takes less than 10 minutes and is done in the comfort of your doctor’s office. There are several options for tests, including the Montreal Cognitive Assessment, the Mini-Mental State Exam, and the Saint Louis University Mental State Exam.
According to the Cleveland Clinic, no matter which exam your doctor offers, they will all focus on these key points:2
· You’ll be asked to give your name, where you are at that moment, and the current date. This helps ensure you are oriented to time, place, and person.
· You will be given a short list of items to remember and asked to recall it a few minutes later. This focuses on your attention span, recall, and short-term learning ability.
· You will be given some five-letter words and asked to spell them forward as usual, then to spell them backward. This reveals information about your concentration.
· Your short-term memory will be tested when you are asked to describe an event that happened in the past few days.
· Your long-term memory will be tested when you are asked to describe an event in the distant past.
· You’ll be asked some questions that focus on abstract thinking. This might include asking you to explain the meaning of a particular phrase or finishing a common analogy.
· You will be asked to read and write, name objects, and repeat phrases. This looks at your ability to use language properly.
· You will be asked to do a simple exercise that reflects language comprehension. For instance, your doctor might ask you to put your left hand on your right knee.
· You will be asked to perform a specific action, such as brushing your hair. This is to show that you understand and can easily follow instruction.
· You will be asked to draw a clock with hands pointing to a specific time. You might also be asked to draw a house or a family scene. This helps show that you understand the relationship between objects and people.
· Your mathematical abilities will be tested by asking you to do simple word problems.
· Your judgment will be assessed by giving you a situation and asking what you’d do if that happened to you.
A low score on the cognitive assessment reveals the need for further testing. A higher score indicates that your brain function is at an appropriate level for your age. The first test provides a baseline that your doctor can refer to in the coming years to compare later tests and determine if your scores have dropped, which could indicate some areas of concern.
Can You Take a Cognitive Test at Home?
Yes, you can. The Self-Administered Gerocognitive Exam, also known as SAGE, is a free screening tool that looks for early signs of memory, thinking, and other cognitive impairments.3 Print out the test and set aside 15 minutes to take it. It looks at many potential issues, including those with orientation, reasoning, memory, and language. However, there is no score provided. You must take the screening test to your doctor to get it scored and interpreted.
What Happens if You Get a Low Score?
If you get a low score on any cognitive assessment, your doctor will likely run the test again just to be sure of the results. If the results are mostly the same, your doctor will move to further testing. Part of that will be ensuring there are no clear problems causing the cognitive decline that could be reversed or stopped.
For example, a low score on the cognitive screening should trigger an in-depth medication review. You might be taking a prescription or over-the-counter drug that is affecting your ability to think and reason. In that case, your doctor could prescribe a different drug and evaluate you again in a month or so to see if the results are the same.
Your doctor will also want to do blood testing to rule out problems like nutritional deficiencies or thyroid issues. You might be asked to take a sleep test to rule out sleep apnea, which can affect your ability to concentrate. Your doctor might even do a brain scan, looking for evidence of small strokes, infections, inflammation, and other problems in the brain that make it hard to think clearly.
These follow-up tests are vitally important, as about half of those found to have mild cognitive impairment had low scores due to some reason other than dementia. For instance, a UTI in an elderly person can often mimic symptoms of dementia; once the UTI is cleared up, that person’s cognitive abilities can go right back to normal.
What if I Have Cognitive Impairment?
If further testing leads to a diagnosis of mild cognitive impairment, don’t panic. Many people live full, happy, and healthy lives with this diagnosis. Your doctor will provide recommendations on lifestyle changes that can help retain and improve your brainpower, such as:
· Getting more sleep. Your brain and body work on repairing themselves during sleep, and getting a good night’s rest can help remove toxins from your brain. Besides that, better sleep means less fatigue, and fatigue can be like a “brain fog” that keeps you from thinking clearly.
· Socializing more often. This can include going to your local senior center for lunches, hitting up trivia night at a local restaurant, talking with friends about issues of the day, and pursuing enrichment for the mind, such as going to plays or watching a movie with others.
· Following the MIND Diet. A modified version of the Mediterranean Diet, “MIND” stands for Mediterranean-DASH Intervention for Neurogenerative Delay. This diet focuses on fresh fruits, vegetables, lean meats, and healthy fats to boost your brain health. These diets are strongly linked to reductions in Alzheimer’s and dementia symptoms.
· Getting plenty of exercise. Numerous studies have found that exercise improves a wealth of cognitive function and can actually reverse some of the trend towards memory loss. Talk to your doctor about exercises that fit your abilities and can keep your brain sharp. (And don’t forget to use an alert system for elderly adults to keep you protected during your workout!)
Your doctor will also look into medications that could help slow cognitive decline or even improve what your brain can do right now. The right medication could add several years of good brain function to your life, so it’s worth taking the time to figure out which one might help you the most.
As you work to keep your brain healthy and strong, let Alert1 provide you with some peace of mind. Studies have shown that falls and other significant injuries in your golden years can actually speed up cognitive decline, and getting prompt medical attention can make a world of difference.
An emergency button alarm for seniors and elderly adults can ensure that if you do suffer a fall, accident, or other emergency, you can get help right away. Alert1 is happy to be able to provide you with such peace of mind!
