Approximately 13 percent of all Maryland residents aged 65 or older have been diagnosed with Alzheimer’s Disease, according to a new report from the Alzheimer’s Association.

The number of people diagnosed with the disease is only expected to increase, according to the report, which anticipates an increase of 18.2 percent in the amount of people diagnosed by 2025.

The increasing number of diagnosis means there will be more people who die from the disease, with nearly 1,200 Marylanders dying from Alzheimer’s in 2017, according to the report. It also raises the number of people in hospice care and who visit the emergency department.

But despite the increasing number of diagnoses, the recent report also suggests there is a number of people who are not getting diagnosed. One in seven U.S. seniors, or 14 percent, get annual cognitive assessments, compared to approximately 80 percent of seniors who have their cholesterol checked, according to the Alzheimer’s Association.

Most primary care physicians agree that seniors need these assessments, according to the association, but less than half include them in their practice’s standard protocol.

Kristin Smedley, a nurse with Privia Health at Frederick Primary Care, does mini-cognitive assessments as part of annual wellness checks. She’ll ask about activities and fall risk, as well as ask questions that allow her to examine a person’s emotional and physical problems, she said.

By reviewing all that with her patient, she is better able to understand a patient’s cognitive state.

She’ll also have them do a “mini-cog” test, where she’ll ask them to repeat three words and draw a clock. A patient gets up to three points for each task, Smedley said.

The “mini-cog” also allows Smedley to have conversations with her patients that will open them up to discussing their mental problems or encourage their family members to start listing examples.

“I try to make the visit fairly relaxed and have a good conversation and get to know the patient,” Smedley said. “But most people will say to me, when I say we’re going to do a memory, I call it a memory evaluation or a memory screening, once I say that the first thing usually they’ll say, ‘Oh I’ve been having trouble.’”

Some patients will pass the mini-cog, even as their family members detail concerns. Other times, if there’s a lot of information up front, they’ll fail. And others in the Alzheimer’s community have raised concerns that people remember the mini cogs, so they are not a good tool for assessing if someone has the disease or if it is progressing.

Smedley said that she’ll often refer people to a neurologist if there are mental concerns. And she always tells patients to follow up with their primary care physicians, she said.

Seniors are often aware of changes in their mental state, according to the Alzheimer’s Association, they just might not want to discuss it. Even if they do not remember, family members will start to chime in.

Smedley said some of the early signs for health care professionals is someone who is disheveled or unable to answer questions.

“It’s just really important, as we get older, to focus on making sure that population can be independent, or if they can’t, then we can get them the help they need,” Smedley said.

Follow Heather Mongilio on Twitter: @HMongilio.

Heather Mongilio is the health and Fort Detrick reporter for the Frederick News-Post. She can be reached at hmongilio@newspost.com.

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