Only 28% of older adults have ever been assessed for cognitive problems, and only 16% undergo routine cognitive assessments during normal health checkups, according to a report released Tuesday by the Alzheimer’s Association. But caregivers can play a role in changing that reality, the authors said.

The survey found that although 51% of all older adults are aware of changes in their cognitive abilities — including changes in their ability to think, understand or remember — only 40% ever have discussed these concerns with a healthcare provider, and only 15% report having ever brought up cognitive concerns on their own.

But almost all primary care physicians said they base their decisions to assess people for cognitive impairment, in part, on reports of symptoms or requests from the individual and his or her family members and caregivers, according to survey data cited in the Alzheimer’s Association 2019 “Alzheimer’s Disease Facts and Figures” report.

“Early detection of cognitive decline offers numerous medical, social, emotional, financial and planning benefits, but these can only be achieved by having a conversation with doctors about any thinking or memory concerns and through routine cognitive assessments,” said Joanne Pike, Dr.P.H., chief program officer for the Alzheimer’s Association.

An evaluation of cognitive function is a required component of the Medicare Annual Wellness Visit covered by the federal insurance plan, but only one-third of seniors are aware that these appointments should include this assessment, according to the report.  

Approximately 5.8 million Americans of all ages have Alzheimer’s dementia; all but 200,000 of that number are over the age of 65, according to updated statistics in the report.

Forty-two percent of assisted living residents have received a dementia diagnosis, according to federal statistics cited in the document. The total national cost of caring for those with Alzheimer’s and other dementias is estimated at $290 billion, not including unpaid caregiving, in 2019, of which $195 billion is the cost to Medicare and Medicaid, the authors said.