scholarly journals IDENTIFYING COGNITIVE IMPAIRMENT WITH PRIMARY CARE IMPLEMENTATION OF THE BRIEF INTERVIEW FOR MENTAL STATUS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S658-S658
Author(s):  
Karen L Gilbert
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mental Status ◽  
Care Practice ◽  
Cognitive Screening ◽  
Palm Beach County ◽  
Primary Care Patients ◽  
Cognitively Intact

Abstract Overview: An estimated 5.7 million Americans are affected by Alzheimer’s disease (AD; 2018 Alzheimer’s disease facts and figures, 2018, p. 367). Cognitive impairment fails to be identified in the primary care setting as often as 76% of the time (Moyer, 2014, p. 793). Screening can identify patients with emerging impairment who might otherwise appear cognitively intact Grober, Wakefield, Ehrlich, Mabie & Lipton, 2017, p.191). Early identification of cognitive impairment promotes evaluation of treatable causes (Possin et al., 2018, p. 150), and access to early treatment for irreversible disease, facilitating future planning (Swallow, 2017, pp. 57, 63). Methods: This quantitative study’s aim was to identify patients with occult cognitive impairment. After training staff in a Palm Beach County Florida primary care practice, the Brief Interview of Mental Status (BIMS) was administered to patients aged 45 years and older. Results: Seven of 120 screened patients, with no known AD diagnosis, scored as moderately impaired. One of these patients was 64 years of age, the remaining six ranged from age 71 to 93. Fourteen patients scored at the lowest range of “cognitively intact,” eight were under age 65. Conclusion: Cognitive screening of primary care patients with no known diagnosis of AD identified approximately 7% scoring as moderately impaired; an additional 12% scored at the lowest range of “cognitively intact,” suggesting a potentially emerging cognitive impairment warranting follow up evaluation for treatable causes, developing AD, or a related neurocognitive disorder.

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.

Mild cognitive impairment in primary care: a clinical review

2018 ◽  
Vol 94 (1117) ◽  
pp. 647-652 ◽  
Author(s):  
Georges Assaf ◽  
Maria Tanielian
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Clinical Review ◽  
Primary Care Physicians ◽  
Early Recognition ◽  
Neuropsychiatric Symptoms ◽  
Evidenced Based

Dementia is projected to become a global health priority but often not diagnosed in its earlier preclinical stage which is mild cognitive impairment (MCI). MCI is generally referred as a transition state between normal cognition and Alzheimer’s disease. Primary care physicians play an important role in its early diagnosis and identification of patients most likely to progress to Alzheimer’s disease while offering evidenced-based interventions that may reverse or halt the progression to further cognitive impairment. The aim of this review is to introduce the concept of MCI in primary care through a case-based clinical review. We discuss the case of a patient with MCI and provide an evidence-based framework for assessment, early recognition and management of MCI while addressing associated risk factors, neuropsychiatric symptoms and prognosis.

scholarly journals Older Primary Care Patients’ Attitudes and Willingness to Screen for Dementia

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Nicole R. Fowler ◽  
Anthony J. Perkins ◽  
Hilary A. Turchan ◽  
Amie Frame ◽  
Patrick Monahan ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Screening Instrument ◽  
Perceived Benefits ◽  
Risks And Benefits ◽  
Dementia Screening ◽  
Primary Care Patients ◽  
Telephone Screening ◽  
Screening Behaviors

Objective. To understand older primary care patients’ perceptions of the risks and benefits of dementia screening and to measure the association between attitudes and screening behaviors.Methods. Eligible patients completed the Perceptions Regarding Investigational Screening for Memory in Primary Care (PRISM-PC) questionnaire and then were asked to undergo dementia screening by a telephone screening instrument.Results. Higher scores on the PRISM-PC questionnaire items that measure attitudes about benefits of screening were associated with decreased odds of refusing screening. Participants who refused screening had significantly lower PRISM-PC questionnaire scores on the items that measure perceived benefits compared to those who agreed to screening. Participants who refused screening were less likely to agree on screening for other conditions, such as depression and cancer. Participants who know someone with Alzheimer’s disease (AD) were less likely to refuse screening.Discussion. Patients’ attitudes about the benefits of dementia screening are associated with their acceptance of dementia screening.

scholarly journals The “Counseling+” Roles of the Speech-Language Pathologist Serving Older Adults With Mild Cognitive Impairment and Dementia From Alzheimer's Disease

2021 ◽  
pp. 1-16
Author(s):  
Alyssa M. Lanzi ◽  
James M. Ellison ◽  
Matthew L. Cohen
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Health Care Professionals ◽  
Systematic Research ◽  
Complex Nature ◽  
Cognitive Screening ◽  
Speech Language Pathologist ◽  
Age Related

Purpose Persons with dementia and mild cognitive impairment (MCI) are major consumers of services provided by speech-language pathologists (SLPs). These services include not only direct assessment and treatment of communication and swallowing but also counseling, collaboration, prevention, and wellness. These “counseling+” activities can be especially challenging for SLPs to deliver because of the lack of evidence, as well as the complex nature of Alzheimer's disease (AD) and other conditions that cause MCI and dementia. Method This tutorial is written by a speech-language pathologist, a neuropsychologist, and a geriatric psychiatrist to provide education, resources, and recommendations for SLPs delivering counseling+ activities to patients with MCI and dementia from AD and related disorders. Results and Conclusions We describe counseling+ activities across the continuum of care ranging from educating and conducting cognitive screenings with adults experiencing age-related cognitive decline to supporting end-of-life wishes. Because of their expertise in communication, SLPs can provide an array of important leading and supporting services to patients, their family, and other health care professionals on the care team, such as providing patients with appropriate feedback following a cognitive screening and helping caregivers identify the communicative intent of a responsive behavior. The demand for SLP services for patients with MCI and dementia will grow significantly over the next few decades, necessitating more systematic research and clinical evidence in this area.

A Guide to Diagnosis of Alzheimer's Disease

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S5) ◽  
pp. 16-19, 28 ◽  
Author(s):  
Mary Sano
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Memory Impairment ◽  
Daily Practice ◽  
Cognitive Change ◽  
Assessment Instruments ◽  
Optimal Management ◽  
Cognitive Screening ◽  
Trial Setting

AbstractA major challenge in the management of Alzheimer's disease (AD) is accurate diagnosis of the condition. Aging itself is associated with cognitive change, and physicians must first distinguish between age-associated complaints and true memory impairment as in AD before optimal management can begin. This article reviews tools used to assess and diagnose AD patients in both the primary care and clinical trial setting. AD assessment instruments commonly used in research may be too cumbersome for use in primary care. Tools specifically designed to meet the needs of busy practitioners that can accurately assess function, cognition, and global change will be reviewed. The issues of cognitive screening in old age and age-associated memory impairment will be discussed. Similarly, the pitfalls and advantages of routine cognitive screening in daily practice will be addressed.

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