Cognitive decline is affecting millions of Americans and they don't know it

Mild cognitive impairment is affecting millions of Americans and they don't even know it according to two research papers published in 2023. But are you suffering from this problem? Let's look at what scientists discovered.

Mild cognitive impairment might not sound like anything you would need to stress about but Fortune’s Erin Prater explained it can be a “potential early sign of Alzheimer’s disease” in her review of the new research on the condition.  

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In July 2023, researchers from the University of California published a study on the rate of mild cognitive impairment in a population data set of forty million Americans aged 65 and older who were Medicare beneficiaries. 

The researchers compared the individuals diagnosed with mild cognitive impairment in their data set with the number they expected to be afflicted by the condition and found something quite alarming.  

It was thought that roughly eight million people in the group of 40 million would suffer from mild cognitive impairment but the researchers found only 600,000 individuals in their dataset had been properly screened. 

The researchers concluded that their results revealed the need to increase the overall detection rates of mild cognitive impairment and dementia, especially among people in socioeconomically disadvantaged groups. 

A worrying 92% of expected mild cognitive impairment cases went undiagnosed in their dataset according to the researchers. Black and Hispanic Medicare beneficiaries in the data set experienced the lowest rates of detection. 

Even more worrying than the previous findings was the revelation that those eligible for Medicare and Medicaid had lower detection rates of mild cognitive impairment than just those who were on Medicare. 

The first study was followed by a second study that included several of the same  researchers that were involved in the first study, and it made equally surprising and concerning discoveries. 

The second also investigated the rate of mild cognitive impairment, but this time researchers revealed even more worrying findings and concluded that undiagnosed cognitive impairment by professionals was much worse then they thought.  

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The second study was published in The Journal of Prevention of Alzheimer's Disease on October 24th and the researchers discovered that mild cognitive impairment was “vastly underdiagnosed” in the United States. 

Using Medicare administrative data for the total population of those over the age of 65, the researchers discovered that 8% of U.S. residents with mild cognitive impairment have not been diagnosed with the disease. 

Gizmodo’s Ed Cara reported that the findings meant as many as 7.4 million Americans don’t know that they could be suffering from mild cognitive impairment and added that the researchers estimated the number could be 10 million if those over 50 were included.

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After looking at data from over 200,000 primary care clinicians and 50,000 practices in the United States, the researchers discovered that 99.9% of primary care clinicians and 99.8% of practices in the U.S. caught cases less than the expected rate of diagnosis.

“It’s a very different conversation to have when we can point to these numbers,” Soeren Mattke, director of the Brain Health Observatory and one of the researchers involved in both of the studies, told Cara about the findings via email.

Cara also noted that most people will experience some form of cognitive decline in their lifetimes but explained that mild cognitive decline is often the first stage of a more serious issue that can lead to Alzheimer’s Disease or dementia. 

This is where screening and early detection are important because even mild cognitive impairment if caught early, has a number of treatment options that can help reverse the condition. But again, only if it's caught early enough. 

“With [mild cognitive impairment], there are actually a chunk of cases that have their easy fixes—some might be caused by medication side effects or vitamin deficiencies, and all kinds of things we can address if cases are detected,” Mattke said

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​“And we are starting to see disease-modifying treatments that might be able to change the trajectory of degenerative conditions like Alzheimer’s,” Mattke continued, adding the “real important takeaway is that this diagnosis is a race against time.”

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