According to recently published research, screening tests widely used in primary care settings frequently fail to correctly classify cognitive status. The Mini-Mental State Examination (MMSE) was one such test. It failed to properly classify up to one third of older adults, as to whether or not they had dementia. Even more astounding was the fact that it was wrong in both directions. Sometimes it said patients had dementia when the didn’t, and vice versa. Imagine the devastating impact on a patient labeled with dementia when they do not have it. Or, alternatively, failing to identify the same serious condition when, in fact, they do have it. Very alarming news indeed, but the sad fact is that it’s not a new discovery! In fact, it’s been known for quite some time and consistently demonstrated in numerous studies. However, the conventional medical system is resistant to change despite the consistent evidence.
In our practice, we understand that diagnosing Alzheimer’s disease and dementia is challenging and complex. Therefore, we rely on a wide array of state of the art tests in order to make the correct diagnosis. Cognitive testing is just one arm of our approach and one which we recommend for our patients who with concern for their cognitive health. In fact, we recommend it for everyone as part of a mid-life assessment in order to establish a cognitive baseline and exclude the possibility of early onset impairment. Dr. Dale Bredesen, a leading Alzheimer’s and dementia researcher and clinician, recommends everyone over age 45 should receive a “Cognoscopy™.” A play on words for the colonoscopy which usually welcomes those arriving at the mid-century mark. It describes a battery of tests measuring biomarkers which are key to the diagnosis of Alzheimer’s disease and often precede its development. (See chapter 7, “The ‘Cognoscopy’ — Where Do You Stand?” in Dr. Bredesen’s book The End of Alzheimer’s)
In addition to advanced cognitive testing, we also Look Deeper™ using a broad array of biomarker testing combined with state of the art advanced imaging modalities, when appropriate. We take into account a wholistic view of each individual’s dementia risk markers which include such things as: family history, midlife obesity, sedentary lifestyle, metabolic syndrome, ApoE status, homocysteine, hs-CRP (high sensitivity C-reactive protein), fasting insulin, Hemoglobin A1c, and more.
What should you do? If you, or someone you care about is at risk of, or starting to show signs of cognitive decline, it’s likely neither too late, or too early for them to receive the comprehensive evaluation they deserve. Don’t rely on cursory questionnaires which fail to deliver an accurate assessment. Don’t accept a cursory pat on the back that “you’re OK” and loose the precious opportunity to reverse the progression. If you’d like to learn more, we would welcome the opportunity to help. Just click on this link to find out more.
PS. If you’d like to take a deep dive into the science, check out this podcast from Dr. Rhonda Patrick “Dr. Dale Bredesen on Preventing and Reversing Alzheimer’s Disease” available on with a transcript on her website, or on YouTube.
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