Mammograms and Severe Dementia - The New Old Age Blog - NYTimes.com

By PAULA SPAN

I’m trying, with some difficulty, to imagine myself as a quite elderly woman in her 80’s, someone with such advanced cognitive impairment that I can correctly answer fewer than a third of the questions on a commonly used test. I might not know who the president is, or what day or date it is; I might not be able to remember a few nouns the test giver just recited. Asked the question, “What is the object used to cut paper?,” I might not be able to come up with the word scissors.

Now, I’m trying to imagine technicians undressing me and getting me set up for a mammogram, a screening test whose purpose I may not understand. I’m betting the test would cause some discomfort (ask me how I know). I might also find it frightening, disorienting, threatening. It’s unlikely to do me any good, and it could do me some harm.

This is not an imaginary scenario.

Epidemiologists at the University of California, San Francisco have been analyzing the Medicare records of women over 70, focusing on a sample of 355 with severe cognitive impairment but no history of breast cancer. They’ve come up with a classic good news/bad news picture.
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