Article Figures & Data
Figures
- Figure 1.
Recommended workflow for early detection of cognitive impairment in primary care.
AWV = annual wellness visit; PCP = primary care practitioner; PRO = patient- or informant-reported outcome (questionnaire).
aAssessment could be completed at the same visit or across several subsequent visits, and could include a validated cognitive screening measure (eg, Montreal Cognitive Assessment), assessment of possible contributing factors (eg, mental health, medications), and/or additional diagnostic testing (eg, neuroimaging, sleep study).
bCould include part or all the components listed in the above footnote.
- Figure 2.
Activating stakeholders to implement a workflow for early detection of cognitive impairment.
Note: To optimally implement a screening workflow, all 3 stakeholder groups must be incentivized. Ideally, incentives common to all 3 groups (denoted by the star) can be identified and serve to move the workflow forward.
Tables
Administration time <10 minutes Minimal training required to administer, score, and interpret Minimally affected by factors unrelated to cognitive impairment (eg, sex, education, language, culture) Acceptable to older adults Sensitivity and specificity ≥80% Sensitive to mild stages of cognitive impairment Assesses both memory and executive function, the domains frequently affected in the most common causes of dementia
PLAIN-LANGUAGE ARTICLE SUMMARY
Special Report
Improving Early Detection of Cognitive Impairment in Primary Care
Background and Goal: The number of people living with Alzheimer’s disease in the U.S. is expected to double to nearly 14 million in 2060. Early detection of cognitive impairment is essential for improving patient outcomes, but primary care settings face significant challenges in screening. Presented at an interdisciplinary Geriatrics Summit hosted by the National Academy of Neuropsychology, this special report summarizes key points and gaps in knowledge about methods for detecting cognitive impairment in primary care clinics.
Key Insights:The report highlights the importance of addressing the rising incidence of cognitive impairment as the population ages, particularly with new treatments for early Alzheimer’s disease now available. It advocates for creative solutions to manage the increased workload, such as partnering with community health workers and leveraging telehealth. Automated tools for risk stratification, cognitive screening, and follow-up are in development, with successful models already integrated into electronic health records. Clinical trials are needed to assess multi-step protocols that combine risk assessment with cognitive screening in primary care and community settings. The report emphasizes the importance of developing cognitive care plans, especially for vulnerable populations, and outlines the need for clear roles between primary care physicians and specialists in managing cognitive disorders.
Why It Matters:Addressing cognitive decline early on can lead to better patient outcomes and improved quality of life. By removing barriers to screening and promoting collaboration between primary care and specialists, more patients can be identified earlier and receive the care they need
Improving Early Detection of Cognitive Impairment in Older Adults in Primary Care Clinics: Recommendations From an Interdisciplinary Geriatrics Summit
Robin C. Hilsabeck, PhD, et al
National Academy of Neuropsychology, Denver, Colorado
The University of Texas at Austin Dell Medical School, Austin, Texas
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