Here's a story about the mammography industry that sounds almost too crazy -- and too greedy -- to be true. But the facts are documented in a new study by University of California at San Francisco (UCSF) researchers. It turns out that unneeded, expensive mammograms are being pushed on elderly women who are incapacitated from Alzheimer's disease or other forms of dementia, especially if the women have savings or assets of $100,000 or more.

The study, which was just published in the January edition of American Journal of Public Health, used 2002 data from the Health and Retirement Study, an ongoing national prospective study sponsored by the National Institute on Aging that is investigating the relationship between health, income, and wealth over time. The researchers were able to document screening mammography rates by compiling information from Medicare claims.

When they looked closely at the mammogram history of 2,131 elderly women with severe cognitive impairment, the research team found nearly 20 percent received mammograms (compared to 45 percent of women with normal mental status) -- even though these women were unlikely to live three more years and mammograms are not indicated for women with a life expectancy of five years or less. However, the rate of mammograms ordered for elderly women with severe dementia went up dramatically if they were married and the couple still had tens of thousands of dollars in assets. In fact, the rate of unnecessary screening mammography for seriously cognitively impaired women soared to nearly 50 percent if they were still married and the couple's net worth was $100,000 or more.

It's important to note that the women who were studied were given mammograms not because a suspicious lump had been detected during a physical exam. Instead, these dementia patients were subjected to screening mammography to see if any hidden masses could be spotted that were not causing any symptoms but could possibly cause problems in the future.

Geriatrics researcher and lead author Dr. Kala Mehta pointed out in a statement to the press that "a woman must have a life expectancy of at least four to five years," for a mammogram to possibly do any good; whereas, the severely cognitively impaired women in this study had a life expectancy of only 3.3 years on average. "Otherwise," she stated, "the potential harms are likely to outweigh the benefits."

What are those harms, specifically? Dr. Mehta lists them as invasive follow-up tests such as biopsies in women who don't have the mental capacity to know what is going on and surgery for asymptomatic lumps that would almost certainly never cause any problems for these women in their lifetimes. What's more, all this unneeded and expensive medical intervention diverts time and money away from the daily needs of women with profound dementia. Bottom line: unnecessary mammograms can cruelly rob these women of whatever quality of life they have left.

The study authors concluded that screening mammography guidelines should be enforced that explicitly recommend against screening severely cognitively impaired older women. "I don't think most people would say that putting a very demented older woman through screening mammography is a good thing," stated principal investigator Louise C. Walter, MD, an associate professor of medicine at UCSF, in the press statement.