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By Dr. Michael Fulks, MD

Test tubes with lab bench visible in background

Dr. Michael Fulks is a Medical Director for Clinical Reference Laboratory (CRL). He is an expert commentator on core issues facing underwriters, providing context to link tests at CRL and disorders of underwriting concern. Dementia is one such concern; it is a condition that impacts mortality and morbidity from an underwriting perspective, and impacts families and lives from a personal perspective. Read more below.

What Science Tells Us About Preventing Dementia is the title of a November article in The Wall Street Journal. It notes that dementia risk by age is decreasing, even though we are an aging population, and none of the drug trials to prevent or slow Alzheimer’s disease have shown benefit thus far. What are the reasons for this apparent contradiction?

Loss of brain cells leading to dementia can occur due to a variety of causes. One is formation of the protein-based plaques and tangles characteristic of Alzheimer’s disease. Another is lack of blood flow due to the presence of vascular disease — even if it is not severe enough to cause a detectable stroke. While there are currently no known, effective strategies to protect the brain from the formation of plaques, there are many such strategies for the prevention of vascular disease. Control of blood pressure, weight, lipids and blood sugar levels are important, and can be impacted by appropriate diet and exercise. Smoking cessation is also critical.

Chart: Cardiovascular disease risk factors

How can these various vascular risk factors be easily quantified for individuals? What is needed is an age- and sex-specific multivariate risk model which includes measures of risk factors like blood pressure, build, lipids, and other known blood- and urine-based markers of vascular disease. The CRL risk assessment tool called Smart Score is just such a model and has been demonstrated to be a strong predictor of mortality risk, a substantial portion of which is due to vascular disease.

Contact CRL at today to learn more about Smart Score and how to utilize it in your insurer and underwriting efforts in 2020.

About the Author

Michael Fulks, MD, Consulting Medical Director, is board-certified in internal and insurance medicine. After leaving practice, he served as a medical director, creating or editing several underwriting manuals and preferred programs. For the past 8 years, Dr. Fulks has consulted for CRL, participating in its mortality research on individual tests and all laboratory test results, BP and build in combination. He is also involved in the development and implementation of automated screening tools for non-laboratory data.

Tags: Alzheimers, Cardiovascular Disease, Dementia, Life Insurance, Underwriting