If I had a frequently asked question list, one of the top ten questions from adult children would be “how do I get my dad/mom to a doctor for a dementia evaluation?”

It’s natural and human to want to avoid an unpleasant truth. For most of us, the aging process brings some very unpleasant truths, as our bodies signal that certain functions are showing signs of wear. The cruelest blow, however, for the majority of us, is when there are signs that the “wisdom of age” is starting to skew toward the negative, as in memory loss and poor judgment due to negative changes in our brains.

Because of this, many aging parents can become extremely stubborn about seeing a doctor to be evaluated for possible dementia. Adult children plead and beg. They threaten. They fuss and push. But Dad or Mom won’t budge.

Often, when I’m asked what they can do, I suggest that they talk the parent into a physical for something totally unrelated to dementia – say blood sugar, if diabetes is a family risk, or blood pressure problems. I tell the adult children, that they can then write the doctor a letter ahead of time, voicing concern about memory decline or other red flags for dementia, citing specific examples if possible.

If the parent can be gotten into a doctor’s office, a good doctor can often take the discussion from there. Traditionally, a quick pencil and paper test known as the Mini Metal State Exam (MMSE), has been considered a good tool, however the results can be influenced by educational levels, and there are copyright issues, as well.

Now, a tool known as the “Sweet Sixteen” is gaining popularity. In a story on eurekalert.org, titled “Sweet 16″ tool may be useful for detecting cognitive impairment, comes news about a verbal test that seems to be fairly accurate. It’s quick, cheap and a knowledgeable doctor can administer it quickly without putting off the person being tested.

The test “…cognitive assessment tool with 16 items appears potentially useful for identifying problems in thinking, learning and memory among older adults…” A study reflecting the accuracy of the test was published last March in the Archives of Internal Medicine, one of the JAMA/Archives journals.

According to the eurekalert article the “Sweet 16 can, “rapidly assess cognitive status in older adults……required no pencil, paper or other props and was easy to administer with a minimum of training…”

This, to me is a significant step forward. If general physicians can be trained to quickly administer this verbal test, they can have a starting point for referrals if the results point in that direction.

There are many reasons for dementia-like symptoms that are not dementia, including infections, medication reactions and/or interactions and vitamin B-12 deficiencies. A good doctor would look for all of these clues when giving a physical, if he or she is alerted ahead to the fact that dementia-like symptoms are present. With the addition of the “Sweet 16″ as a quick tool, the physician would have a clearer picture of the elder’s cognitive abilities.

Back to getting the parent to a doctor. If the aging parent balks at even a general physical, try to get an old friend to suggest a doctor visit. Often elders will respond better to someone outside of the family. Parents like to be parents, after all. A third party can often help them save face and see that they must do something.

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