Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Survey asks adults: How likely are you to develop dementia?

Key clinical point: Many adults worry that they’re likely to get dementia, but hardly any discuss that concern with their physician.

Major finding: Just 5% of survey respondents had participated in a conversation with a clinician about dementia.

Study details: The survey was taken by 1,019 adults aged 50-64 years.

Disclosures: Dr. Maust had no disclosures.


Maust D et al. JAMA Neurol. 2019 Nov 15. doi: 10.1001/jamaneurol.2019.3946.


I do not find it surprising that older adults fear dementia. Since they correctly perceive that there is no disease-modifying therapy (and maybe also that “getting caught with memory loss” would lead to a loss of driving privileges and other restrictions), they may be trying not to focus on it. As for asking about strategies to “prevent” dementia, that question implies unwarranted optimism about the effectiveness of any such strategy, especially in an older adult. I think we can say that a lifetime of healthy habits (regular physical exercise and careful control of any chronic conditions like diabetes being particularly important) may reduce our risk of dementia a bit, but the idea that anything a 75-year-old does is going to prevent it at that point is probably wishful thinking. Supplements and the like seem to have their own followers. It amazes me how many people suspect what they are taking probably does no good but they do it anyway out of blind hope. Sometimes we can talk them out of spending their money on such things – but not always.

Richard Caselli, MD, is associate director and clinical core director of the Alzheimer’s Disease Center at the Mayo Clinic in Scottsdale, Ariz.