First-of-Kind Study Looks at Impact of Cognitive Impairment Status in Primary Care
Doctors who are given information on a patient's cognitive status did provide more care focused on cognition but it did not impact the patient's overall rate of cognitive decline, according to a clinical trial published in Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring.
Study authors conducted a study of 533 older adults from western Pennsylvania and doctors in 11 primary care practices who provided their care from 2005–2008. Physicians in six practices and their patients received cognitive performance reports whereas physicians in the other five practices and their patients did not receive the reports. Doctors with a patient's report indicating mild cognitive impairment or possible dementia also got information about the patient's health status and medications that may be impacting their condition, and reminders to check for reversible causes of memory loss (eg, B12 deficiency, low thyroid levels, drug reaction or interaction).
Physicians with available data on their patient's cognitive function were more likely to order diagnostic tests (P=0.002) and talk about memory difficulties with patients (P=0.003) compared to physicians who were not made aware of their patients' cognitive status. These patients were also more likely to be taking a prescription or non-prescription cognition-based drug over the two-year study duration compared to patients not aware of their cognitive status. However, there was no difference in the rate of cognitive decline between the two groups.
Researchers concluded that having available patient cognitive information had some impact on physician behavior, but it had little impact on patient outcomes. A more significant response may come once more effective treatments and support programs are available. Healthcare trends are pointing to the fact that many older adults will be obtaining care from general practitioners rather than dementia specialists, which places an emphasis on primary care settings to identify cognitive impairment or changes.
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