Nicole Fowler, PhD, discusses early detection and intervention for Alzheimer’s disease and related dementias and why she focuses on family caregivers.
Transcript:
Screening alone for Alzheimer’s disease and dementia isn’t enough, because just identifying people who may be at risk and not having an evidence-based diagnostic assessment and then an opportunity for evidence-based care and treatment, that’s the ultimate way to be able to care for patients. The United States Preventive Services Task Force, which is an organization that helps set guidelines for care — in particular, in primary care around screening, has often said that we don’t quite know if the evidence for screening people for Alzheimer’s disease and dementia if the benefits outweigh the risks.
There’s a huge amount of stigma around what changes in your brain can mean for the way you behave, the way you remember, the way you interact with other people. And that’s what we’re trying to decrease, because can we cure Alzheimer’s disease? No. But can we actually improve the experience that people have? Absolutely.
That’s why we decided to focus on family members of older adults with this idea that being able to identify potential early cognitive impairment and let the patient and the family member and their provider know, that we could actually intervene early.
We really did design the study to be able to understand what would be any potential psychological harms for both patients and for family members — so things like depression and anxiety — and we found that no, screening older adults does not actually induce short-term or long-term psychological harm for patients or for their family members.
Close to 40 percent of the patients who screened positive did not actually go on to get that next step, and so, I think you really can’t disassociate the early detection from screening with the actual pathway that would ultimately produce benefits.
Caregivers don’t need answers with regard to how their family member’s brain health is. They actually need to know how it is in relation to the things that they need to be able to do to function. What are the tools and resources and skills that I need to have as a family member to be able to provide that care if and when they need it?
We may not be able to cure Alzheimer’s disease, but we certainly can help manage their other things better if we know that they’re having problems doing it on their own.
