Assessment and management of patients with cognitive impairment and dementia in primary care.

The Journal of Nutrition, Health & Aging
J BelminNeil S Wenger

Abstract

To evaluate care provided by primary care physicians in community practice to older patients presenting with cognitive impairment and dementia. Secondary analysis of an intervention study. Primary care clinics. 101 patients 75 years and older enrolled in the ACOVE-2 study who presented with a new cognitive problem, new dementia, or prevalent dementia. Patients assessment and management were evaluated from medical record review and caregiver interviews. Among 34 patients presenting with a new cognitive problem, half received a cognitive assessment comprising of a test of memory and one other cognitive task, 41% were screened for depression and 29% were referred to a consultant. Of the 27 patients with newly diagnosed dementia, 15% received the components of a basic neurological examination, one-fifth received basic laboratory testing and for one third the medical record reflected an attempt to classify the type of dementia. Counseling was under-reported in the medical record compared to the caregiver interview for the 101 patients with dementia, but even the interview revealed that about half or fewer patients received counseling about safety and accident prevention, caregiver support or managing conflicts. Less than 10% were re...Continue Reading

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Citations

Feb 18, 2015·Journal of the American Geriatrics Society·Lee A JenningsNeil S Wenger
Oct 25, 2016·Journal of the American Geriatrics Society·Joe VergheseJessica Zwerling
Apr 9, 2014·Health Affairs·Zaldy S TanDavid Reuben
Aug 7, 2020·Journal of Clinical Nursing·Soraia TelesAna Ferreira
Sep 12, 2020·Aging & Mental Health·Rachael FrostUNKNOWN PriDem team

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