confusion elderly
Alzheimer's Disease and other Dementias

Undiagnosed Dementia Puts Elders at Risk

According to the World Health Organization, 47.5 million people worldwide are living with dementia, a number that is expected to more than triple by 2050. A diagnosis of dementia is frightening and overwhelming for those who have it and for their families. Early detection is critical to ensure quality care and to enable patients and families to plan for the future. Early treatment can slow and in some cases even reverse cognitive decline.

In its earliest stages, dementia is not easy to detect and studies have suggested that as many as half of those with dementia are undiagnosed. When a diagnosis of dementia is missed or delayed, people in the early stages of dementia continue to engage in behaviors that may be disastrous; primarily risking financial abuse and fraud, but also driving, managing medications, and sometimes caring for another person. Family members, especially if they don’t live with their elder relative, may be unaware that cognitive decline is causing functional impairment. This oversight can have devastating consequences.

Dementia is not a disease. It is an umbrella term for a group of illnesses that have different causes but similar symptoms. Those symptoms might include varying degrees of memory loss, language difficulty, poor judgment, inability to concentrate, personality changes, and impaired visual perception. But the initial signs can be difficult to spot. They may be transient or they may be mistaken for the “senior moment” instance of memory loss that is a natural consequence of aging. A person may seem like “themselves” – perfectly lucid and functioning well – on one day but agitated, confused and angry or withdrawn the next.

Initial signs and symptoms can be subtle and can vary considerably from one individual to the next. In the past, uncertainty might have led to years of gradual decline and its attendant risks before a diagnosis was made. Fortunately, most people are more aware now of the signs of dementia and the lead time before diagnosis has been reduced. Primary care physicians are also more actively involved and routinely ask elders and their families about memory and ability to function. And yet, the subtle changes in judgment, and risk assessment are often missed in evaluation.