Impact of cognitive impairment on screening mammography use in older US women.

TitleImpact of cognitive impairment on screening mammography use in older US women.
Publication TypeJournal Article
Year of Publication2010
AuthorsMehta, KM, Fung, KZ, Kistler, CE, Chang, A, Walter, LC
JournalAm J Public Health
Volume100
Issue10
Pagination1917-23
Date Published2010 Oct
ISSN Number1541-0048
Call Numbernewpubs20101012_Mehta.pdf
KeywordsAged, Aged, 80 and over, Cognition Disorders, Female, Humans, Incidence, Longitudinal Studies, Mammography, Medicare, Patient Acceptance of Health Care, Social Class, United States
Abstract

<p><b>OBJECTIVES: </b>We evaluated mammography rates for cognitively impaired women in the context of their life expectancies, given that guidelines do not recommend screening mammography in women with limited life expectancies because harms outweigh benefits.</p><p><b>METHODS: </b>We evaluated Medicare claims for women aged 70 years or older from the 2002 wave of the Health and Retirement Study to determine which women had screening mammography. We calculated population-based estimates of 2-year screening mammography prevalence and 4-year survival by cognitive status and age.</p><p><b>RESULTS: </b>Women with severe cognitive impairment had lower rates of mammography (18%) compared with women with normal cognition (45%). Nationally, an estimated 120,000 screening mammograms were performed among women with severe cognitive impairment despite this group's median survival of 3.3 years (95% confidence interval = 2.8, 3.7). Cognitively impaired women who had high net worth and were married had screening rates approaching 50%.</p><p><b>CONCLUSIONS: </b>Although severe cognitive impairment is associated with lower screening mammography rates, certain subgroups with cognitive impairment are often screened despite lack of probable benefit. Given the limited life expectancy of women with severe cognitive impairment, guidelines should explicitly recommend against screening these women.</p>

DOI10.2105/AJPH.2008.158485
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/20075325?dopt=Abstract

Endnote Keywords

Cognition Disorders/Mammography/Medicare

Endnote ID

23540

Alternate JournalAm J Public Health
Citation Key7497
PubMed ID20075325
PubMed Central IDPMC2936976
Grant ListK01 AG025444 / AG / NIA NIH HHS / United States
K-01AG025444-01A1 / AG / NIA NIH HHS / United States
U01 AG009740 / AG / NIA NIH HHS / United States
P30 AG015272 / AG / NIA NIH HHS / United States
P30 AG 15272 350 / AG / NIA NIH HHS / United States
U01AG009740 / AG / NIA NIH HHS / United States