The Alzheimers Association recommends routine monitoring of cognitive decline
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Many physicians are failing to perform recommended annual cognitive assessments for dementia patients, according to new data from Motive Medical Intelligence.
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An analysis of more than 100 million U.S. insurance claims found wide variation by state, with failure rates as high as 80%.
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Experts warn that skipping routine assessments can delay critical interventions and worsen outcomes for millions of patients.
A new analysis highlights a significant gap in dementia care across the United States, revealing that many physicians are not following widely accepted guidelines to regularly assess cognitive function in patients with the condition.
Motive Medical Intelligence (Motive) examined more than 100 million closed U.S. insurance claims and found that a substantial number of doctors fail to conduct even a single annual cognitive assessment for dementia patients. The findings come despite strong consensus among professional organizations such as the American Psychiatric Association and the Alzheimers Association, which recommend routine monitoring of cognitive decline.
The issue is particularly concerning given the growing scale of dementia in the U.S. More than sixmillion adults are currently living with the condition, a number projected to nearly double to 13.9 million by 2060. The financial toll is also steep, with costs estimated at $344 billion in 2020 and expected to soar to $3 trillion by mid-century.
Performance varies by state
According to the analysis, physician performance varies widely by state. Alaska ranked as the poorest performer, with 80% of physicians failing to screen dementia patients annually. Vermont and Hawaii also showed high failure rates of 65% and 60%, respectively.
Larger states performed somewhat better but still showed significant gaps. Texas had a 38% failure rate, New York 39%, and California 47%, indicating that even in high-population areas, many patients are not receiving recommended monitoring.
Even the top-performing states fell short of ideal standards. Utah reported a 24% failure rate, followed by Delaware at 25%, and Nevada at 27%, underscoring that no state has fully addressed the issue.
Cognitive assessments are easy to perform with simple tests, such as the Mini-Mental State Examination or Montreal Cognitive Assessment, said Dr. Rich Klasco, chief medical officer at Motive. These tests measure memory, insight, and other aspects of brain function. Tracking changes in these tests over time can assist patients, families, and caregivers in identifying problems and making informed decisions.
Regular monitoring promotes better care
Research has long shown that regular cognitive monitoring helps clinicians detect functional decline earlier and supports timely medical and care-planning interventions. It also plays a key role in preparing patients and families for transitions in care as the disease progresses.
When clinicians fail to measure cognitive function over time, they lose critical insight into disease progression, complications, and safety risks, Dr. Klasco said. This denies patients and caregivers the support they need.
With dementia cases expected to rise sharply as the population ages, experts say improving adherence to routine cognitive screening represents a major opportunity to enhance care quality, reduce avoidable complications, and better support patients and their families.
Posted: 2026-04-02 12:28:34

















