Older adults with probable dementia often take part in unsafe activities

[June 04, 2016]  By Kathryn Doyle

(Reuters Health) – Older adults with signs of probable dementia but no formal diagnosis are much more likely to drive, cook and manage their medications and finances than those with a formal diagnosis, which may be unsafe, according to a new study.

“Just because someone has dementia doesn’t mean they can’t do these things on their own. But if both physicians and families are aware, then they can get safeguards in place,” said study leader Dr. Halima Amjad of the Johns Hopkins University School of Medicine's Division of Geriatric Medicine and Gerontology in Baltimore.

The researchers analyzed data from more than 7,600 participants in the National Health and Aging Trends Study, which has been gathering health information for Medicare beneficiaries age 65 and older since 2011.

Participants have periodic physical and cognitive exams as well as interviews to assess their health as they age.

About 1,000 participants had “probable dementia” based on their performance on cognitive tests, including 457 who had a formal dementia diagnosis.

“Likely some of them are very early in the disease which is why it hasn’t been diagnosed yet, but we know dementia is underdiagnosed,” Amjad told Reuters Health by phone.

Reasons for underdiagnosis can include patient denial or unawareness of their own symptoms, or physicians’ reluctance to formally diagnosis a condition that has no treatment, she said.

Compared to participants without cognitive problems, those with dementia – whether diagnosed or not – were less likely to take part in unsafe activities.

But 28 percent of those with undiagnosed dementia were driving, compared to only 17 percent of those with diagnosed dementia.

Almost 30 percent of people with undiagnosed dementia were still handling their own finances and 42 percent were preparing hot meals for themselves, compared to 12 percent and 17 percent, respectively, of those with a dementia diagnosis, as reported in the Journal of the American Geriatrics Society.

Ultimately a person with dementia will not be able to complete these tasks at all, Amjad said.

“There are steps a family can take while a person is semi-independent,” like using webcams in the home to monitor what’s happening or to automatically turn off a stove, she said.

Earlier diagnosis helps families put these safeguard in place and have more time to prepare for safety issues, rather than making decisions in a time of crisis, she said.

“It’s a case by case basis to say what a person can do and what they can’t do,” Amjad said.

SOURCE: http://bit.ly/1VBPm0o The Journal of the American Geriatrics Society, online June 2, 2016.

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