Kevin Ryan Parks
Dementia-related tools common to several medical societies and organizations that can be used by primary care physicians in diagnosing dementia, according to data presented at the American Geriatric Society Annual Scientific Meeting.
“Access to specialty clinics is limited; there is a need to develop a high-value model of dementia care into primary care setting,” Kevin Ryan Parks, MD, geriatrics fellow at the Mayo Clinic, and colleagues wrote.
Researchers noted clinical areas were PCPs said they had “low confidence.” They then used dementia tools from CMS, the Alzheimer’s Association and American Academy of Neurology to develop a sample cognitive assessment visit that addressed the PCPs’ knowledge gaps.
The prototype included guidance on obtaining patients’ cognitive decline histories; performing structured functional and cognitive assessments, medication reconciliations, and safety evaluations; providing advanced care planning and appropriate referrals; and creating a follow-up plan.
Parks and colleagues reported that in 27 PCP-patient visits that implemented the prototype, either formal cognitive testing was performed, activities of daily living were recorded, a safety checklist was provided or screening for depression occurred during more than 75% of the visits and sometimes in as many as 96% of them, leading to 19 dementia diagnoses.
The prototype’s implementation did have some difficulties, Parks told Healio Primary Care.
“The various scales and tools are time consuming to administer. To maximize our time spent face-to-face with patients and family during education and counseling, we are working with our nursing and allied-health professionals to find more effective methods,” he said in an interview.
He noted that the frequency of dementia and the toll the disease takes should encourage PCPs to overcome barriers when creating their own cognitive assessment visit template.
“The impact of dementia on an individual, family, and society cannot be understated. One new case of dementia occurs each 7 seconds,” Parks said.
“The first medical professional patients and caregivers will address concerns about their memory with is likely to be their primary care provider, so PCPs should be aware that patients and caregivers have concerns about cognition, and cognitive assessment visits are possible and reimbursable,” he added. – by Janel Miller
Reference: Parks KR, et al. “A new approach to dementia care: Cognitive consults integrated within the primary care practice.” Presented at: American Geriatrics Society Annual Scientific Meeting. May 2-4, 2019, Portland, Oregon.
Disclosure: Parks reports no relevant financial disclosures. The other authors’ relevant financial disclosures could not be determined prior to publication.