Study: Elderly Women With Dementia Subjected to Unneeded Mammograms

A survey of thousands of women nationwide indicates that, among elderly women with dementia, the percentage receiving a screening mammogram more than doubles when the women are married and well-off. That people with someone to care for them and money in the bank receive more health treatment than the poor, lonely, and helpless shouldn't come as a surprise. But the UCSF study's second claim may: More treatment is not a good thing.

The study's lead author, Dr. Kala Mehta, told SF Weekly that for women aged 70 or more and suffering from dementia, a screening mammogram will likely do more harm than good.

Statistics, she says, indicate that for such a procedure to be beneficial, a woman must have a life expectancy of at least five more years. But for 70-year-old dementia patients, that's a rarity: The average lifespan is barely over three years.

Yet, when one ventures beyond numerical rationales like the above and considers the actual circumstances, this becomes a powerfully uncomfortable subject. For aged women with "severe cognitive impairment" -- the term the researchers use in lieu of "dementia" -- a mammogram can be a horrifying experience. Many simply may not realize what is happening and might not understand why they are being forced to undergo a painful and unpleasant exam. To them, this is unexplained torture.

What's more, even if the mammogram turns up positive, these elderly women may end up undergoing extensive and unpleasant treatments for conditions that aren't really a concern for someone with only 36 months to live.

Mehta hopes her study leads to a woman's level of cognitive impairment becoming a criteria when it comes to prescribing mammograms. A 75-year-old who's sharp as a tack and could outlive us all ought not to be graded the same as someone suffering from severe dementia with an extremely grim life expectancy. She feels the current guidelines -- or lack thereof -- might be diverting doctors' time and attention away from the day-to-day concerns of dementia patients and focusing on conditions they'll never live to suffer from.

You can read the UCSF study here:

Mammog paperfinal[1].doc