5 for 50: 5 Minutes to Screen People Aged 50 and Older
The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” While mental health is essential to overall health and well-being, mental health problems are often under-recognized and under-treated, especially for older adults. Fortunately, US public health policy, especially as it pertains to persons 50 and older, has made a significant pivot toward advocacy of mental health initiatives. Heightened attention to mental health in this population is justified by high prevalence rates of mental illness, predicted increases in cognitive-functional hardship, and greater caregiver burden. The Centers for Disease Control and Prevention (CDC) estimates that 20% of people 55 years or older experience some type of mental health concern. The CDC highlights the prominence of three mental health concerns for older adults: cognitive impairment, depressive symptoms, and anxiety disorders.
The BCAT Research Center has developed a specific public health initiative that supports routine screening of cognitive and mood functioning. This initiative aligns with the general direction of US public health policies. We call our program “5 for 50”. In five minutes, one can screen for both cognitive and mood problems in people aged 50 and older. The rationale for beginning this screening at age 50 is based on the growing arc of cognitive and mood problems associated with aging, and the importance of introducing mitigation strategies in the form of early detection. These, of course, begin with identification of problems and focused education outreach.
The “5 for 50” program combines administration of the BCAT-SF and the BADS, and addresses the three primary mental health screening targets. The BCAT-SF is an abbreviated or “short form” of the full BCAT that can be administered in 2-3 minutes and has strong psychometric properties. It can be used to identify and differentiate people with normal cognition, mild cognitive impairment, and more significant cognitive impairment (i.e., dementia). The BADS is a brief anxiety and depression scale that can be administered in two minutes or less to identify people with probable depression and anxiety.
We recommend annual “5 for 50” screenings for those with no history of cognitive and mood impairment, and biannual screenings for those with either a history of impairment or active cognitive, depression, and/or an anxiety symptoms.