A new RAND report asserts that a person’s cognitive abilities, functional limitations, and physical health can significantly forecast the likelihood of developing dementia up to two decades before the disease manifests. This finding underscores the vital role of early cognitive assessments in mitigating the adverse effects associated with the loss of financial and physical autonomy.
Emerging research highlights the benefits of early detection of cognitive impairments, enabling individuals to take proactive steps to prepare for potential declines in their financial and physical independence. However, the current uptake of cognitive testing among older adults could be much higher. Further studies suggest that the availability of cost-free and easily accessible cognitive assessments and advancements in treatments could substantially increase their usage.
The critical nature of early detection of Alzheimer’s disease and related dementias, particularly among the 58 million Americans aged over 65, cannot be overstated. This urgency is driven by the fact that existing disease-modifying treatments are only effective in the early stages of the disease. Yet, only 16% of seniors receive such assessments during routine health visits.
RAND researchers undertook three studies to identify individuals at heightened risk of cognitive decline, boost the prevalence of cognitive testing among older adults, and encourage continuous care for brain health among those at risk. The first study utilized data from the Health and Retirement Study to identify early indicators of dementia risk well before its onset. It revealed that lifestyle choices such as inadequate exercise, obesity, and a lack of engagement in hobbies at age 60 are significant predictors of future dementia.
The research also pointed to regional disparities, with individuals born in the Southern United States exhibiting a higher likelihood of developing dementia, even when accounting for various other factors. Interestingly, while certain demographic groups appeared more vulnerable, race and ethnicity ceased to be predictors once factors like education and income were considered. Family health history, size, and marital history were found to be less predictive of dementia.
Peter Hudomiet, the lead author and a senior economist at RAND, emphasized that understanding these risk factors enables healthcare providers and policymakers to target interventions more effectively to those most at risk, potentially delaying cognitive decline or mitigating its impacts.
Another study explored how individuals reacted upon learning about potential cognitive impairments. It found that those newly diagnosed with dementia were significantly more likely to take preparatory actions for the future, such as seeking financial help from family or setting up living wills, compared to those without a diagnosis. This proactive behaviour was observed even among individuals not officially diagnosed but who recognized signs of cognitive issues through survey measures.
A third study by RAND surveyed a national sample to assess barriers to seeking cognitive evaluations and treatment. The study identified cost as the primary deterrent. Most respondents indicated they would be more likely to undergo cognitive testing if it were free, highlighting the impact of financial barriers on health-seeking behaviour. The promise of more effective treatments was also a strong motivator for seeking medical advice, with many expressing willingness to adopt therapies that could prolong their independence.
In conclusion, the comprehensive research by RAND illustrates the intricate interplay between cognitive health and later life outcomes. It underscores the necessity of broadening access to cognitive assessments as a strategic approach to enhance early detection and treatment of Alzheimer’s and related dementias, providing individuals with valuable insights to better prepare for their future health needs.
More information: Peter Hudomiet et al, Identifying Early Predictors of Cognitive Impairment and Dementia in a Large Nationally Representative U.S. Sample, RAND. DOI: 10.7249/RRA3207-1
Journal information: RAND Provided by RAND Corporation
