Fewer rural Alzheimer’s patients with early onset

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COLUMBUS, Ohio – New research has found that rural Americans who have early-onset Alzheimer’s disease are less likely to be seen by specialists and receive tests that benefit both them and their families.

While the majority of Alzheimer’s patients are over the age of 65, about 6% have an early onset between the ages of 30 and 65 and typically experience a more aggressive, rapid cognitive decline. The new Ohio State University study found rural patients were more likely to be seen exclusively by a primary care physician and less likely to be seen by a clinical psychologist. They were also less likely to undergo neuropsychological tests, which help doctors diagnose the condition, treat symptoms and monitor disease progression.

When dementia occurs at a young age, timely specialist care can help patients and families plan for their future and make decisions about work, living conditions and other matters, lead author Wendy Yi Xu of the Ohio State College of Public said to The Health.

The research is the first to examine these differences and appears today (August 5) in JAMA network open. Researchers examined commercial health insurance claims data from 8,430 patients newly diagnosed with early-onset Alzheimer’s disease or related dementia.

“Specialist care, including neuropsychological evaluation, is quite important for people with dementia to get an accurate diagnosis and set up a symptom management plan,” Xu said. “These are advanced, complex tests that most general practitioners are not trained to perform.”

The tests are designed to identify possible causes of changes in cognitive function and play an important role in the diagnosis and treatment of dementia. Assessments include assessments of cognition, sensory perception, language skills, abstract reasoning, and other aspects of learning and understanding, and are typically conducted by neuropsychologists.

While treatment options are fairly limited and there is no cure for Alzheimer’s, careful monitoring of its progression can empower patients and caregivers by providing them with data to help them make decisions, such as whether or not they should eat. B. whether they continue to work or for how long, Xu said, noting that many people are employed and support their families when they receive the diagnosis. Appropriate specialist care can also be very important in managing behavioral and psychological symptoms of dementia and in extending patients’ time at home and in the community.

“These people are young — in their 50s and early 60s — and many are still the primary caretakers to elderly family members and children. They’re still working, paying mortgages and living active lives,” she said.

“If you can diagnose it early enough, patients and family members can prepare, make financial arrangements, plan important events, and seek the support they need, which can improve the quality of life for everyone involved.”

Relying solely on GPs and nurses, who lack specialized training, disadvantages rural patients and overwhelms providers – many of whom have already thinned out in areas with insufficient healthcare infrastructure, Xu said.

As diagnoses of early-stage Alzheimer’s increase, “community health care officials and policymakers must explore innovative solutions to provide patients with early-onset disease with the specialized care they need,” Xu and her co-authors wrote.

Solutions Xu sees include increasing the use of telemedicine visits to specialists, providing additional dementia education for primary caregivers, and increasing the availability of regular specialist consultations for primary caregivers.

The study’s co-authors include Ohio State’s Sheldon Retchin and Yiting Li, George Mason University’s Jeah Jung, and Pennsylvania State University’s Soumyadipta Roy.

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CONTACT: Wendy Yi Xu, [email protected]

Written by Misti Crane, 614-292-3739; [email protected]


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