Approach the Older Patients with Cognitive Impairment in Primary Care

2022 ◽  
pp. 155-168
Author(s):  
Neziha Ulusoylar ◽  
Fatma Sena Dost ◽  
Pinar Soysal ◽  
Ahmet Turan Isik
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Older Patients

scholarly journals Factors Associated With Primary Care Physicians’ Recognition of Cognitive Impairment in Their Older Patients

2014 ◽  
Vol 28 (4) ◽  
pp. 320-325 ◽  
Author(s):  
Mary C. Tierney ◽  
Gary Naglie ◽  
Ross Upshur ◽  
Liisa Jaakkimainen ◽  
Rahim Moineddin ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Primary Care Physicians ◽  
Older Patients ◽  
Factors Associated

Screening for Cognitive Impairment in Hospitalized Older Patients

GeroPsych ◽  
2020 ◽  
pp. 1-8
Author(s):  
Katharina Geschke ◽  
Veronika Weyer-Elberich ◽  
Harald Binder ◽  
Andreas Fellgiebel
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Cognitive Impairment ◽  
Hospital Stay ◽  
Gold Standard ◽  
Older Patients ◽  
Screening Method ◽  
Structured Interview ◽  
Cognitive Status ◽  
Second Step

Abstract. This study develops a screening method for older patients based on nursing procedure to predict complications associated with cognitive impairment during a hospital stay. This multicenter diagnostic cohort study among older hospitalized patients was carried out in eight primary-care hospitals. Following admission of the patients, trained nurses conducted a structured interview and the Mini-Cog as gold standard for cognitive status; complications during the hospital stay were also monitored. In a second step, the structured interview combined with the Mini-Cog revealed whether there was any abnormality in the interview, making it possible to validly and reliably as well as sensitively and specifically identify patients with a pronounced cognitive impairment who may likely suffer from complications during a hospital stay.

Cognitive Impairment in Older Patients Receiving Care in an Urban Primary Care Practice

2016 ◽  
Vol 24 (3) ◽  
pp. S79-S81
Author(s):  
Raisa Epistola ◽  
Jennifer Henry ◽  
Amy Holland ◽  
Olga Achildi ◽  
Mary Morrison
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Older Patients ◽  
Primary Care Practice ◽  
Care Practice

Primary Care for Older Patients Will Get Scarcer

2008 ◽  
Vol 41 (17) ◽  
pp. 45
Author(s):  
JOYCE FRIEDEN
Keyword(s):  
Primary Care ◽  
Older Patients

scholarly journals Negotiating complementary and alternative medicine use in primary care visits with older patients

2012 ◽  
Vol 89 (3) ◽  
pp. 368-373 ◽  
Author(s):  
Christopher J. Koenig ◽  
Evelyn Y. Ho ◽  
Vivien Yadegar ◽  
Derjung M. Tarn
Keyword(s):  
Primary Care ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Older Patients ◽  
Medicine Use ◽  
Complementary And Alternative

scholarly journals Preliminary Results of MyCog, a Brief Assessment for the Detection of Cognitive Impairment in Primary Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 259-260
Author(s):  
Laura Curtis ◽  
Lauren Opsasnick ◽  
Julia Yoshino Benavente ◽  
Cindy Nowinski ◽  
Rachel O’Conor ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Cognitive Aging ◽  
False Positive ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Self Report ◽  
Card Sorting ◽  
Primary Care Settings

Abstract Early detection of Cognitive impairment (CI) is imperative to identify potentially treatable underlying conditions or provide supportive services when due to progressive conditions such as Alzheimer’s Disease. While primary care settings are ideal for identifying CI, it frequently goes undetected. We developed ‘MyCog’, a brief technology-enabled, 2-step assessment to detect CI and dementia in primary care settings. We piloted MyCog in 80 participants 65 and older recruited from an ongoing cognitive aging study. Cases were identified either by a documented diagnosis of dementia or mild cognitive impairment (MCI) or based on a comprehensive cognitive battery. Administered via an iPad, Step 1 consists of a single self-report item indicating concern about memory or other thinking problems and Step 2 includes two cognitive assessments from the NIH Toolbox: Picture Sequence Memory (PSM) and Dimensional Change Card Sorting (DCCS). 39%(31/80) participants were considered cognitively impaired. Those who expressed concern in Step 1 (n=52, 66%) resulted in a 37% false positive and 3% false negative rate. With the addition of the PSM and DCCS assessments in Step 2, the paradigm demonstrated 91% sensitivity, 75% specificity and an area under the ROC curve (AUC)=0.82. Steps 1 and 2 had an average administration time of <7 minutes. We continue to optimize MyCog by 1) examining additional items for Step 1 to reduce the false positive rate and 2) creating a self-administered version to optimize use in clinical settings. With further validation, MyCog offers a practical, scalable paradigm for the routine detection of cognitive impairment and dementia.

scholarly journals Promoting Conversations About Cognitive Decline Between Older Adults and Primary Care Providers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 157-158
Author(s):  
Benjamin Olivari ◽  
Christopher Taylor ◽  
Nia Reed ◽  
Lisa McGuire
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Chronic Conditions ◽  
Memory Loss ◽  
Primary Care Providers ◽  
Subjective Cognitive Decline ◽  
Care Providers

Abstract Alzheimer’s disease and related dementias often begin with symptoms of mild memory loss, eventually leading to more severe cognitive impairment, functional impairment, and ultimately, death. Data from the Behavioral Risk Factor Surveillance System core questions related to chronic diseases and from the cognitive decline optional module on subjective cognitive decline (SCD) from the years 2015-2018 were aggregated across the participating 50 states, D.C., and Puerto Rico for this analysis. Among U.S. adults aged 65 years and older, only 39.8% (95%CI=37.6-42.1) of those experiencing SCD reported discussing their SCD symptoms with a healthcare provider. The prevalence of discussing SCD symptoms with a provider was higher among those with at least one chronic condition than among those with no chronic conditions. 30.7% (28.6-32.8) of those aged 65 years and older reported that their SCD led to functional limitations and 28.8% (26.5-31.2) needed assistance with day-to-day activities. For patients aged 65 years and older, Welcome to Medicare visits and Medicare Annual Wellness Visits are critically underutilized primary care access points. Primary care providers can manage chronic conditions, cognitive health, and initiate referrals for testing. Efforts to promote the use of toolkits and diagnostic codes that are available to primary care providers to initiate conversations about memory loss with patients may be utilized to improve detection, diagnosis, and planning for memory problems. Discussions may lead to earlier detection and diagnosis of cognitive impairment, such as Alzheimer’s disease, or other treatable conditions such as delirium or pressure in the brain and avoid costly hospitalizations.

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