Cognitive testing in older primary care patients: A cluster‐randomized trial. Issue 3 (21st July 2015)

• Record Type: Journal Article
• Authors: Fowler, Nicole R.; Morrow, Lisa; Chiappetta, Laurel; Snitz, Beth; Huber, Kimberly; Rodriguez, Eric; Saxton, Judith
• Is Part Of: Alzheimer's & dementia. Volume 1:Issue 3(2015)
• Page Start: 349
• Page End: 357
• Publication Date: 2015-07-21
• Subjects: Age -- Alzheimer's disease -- Community‐based -- Cognitive impairment -- Dementia -- Mild cognitive impairment primary care -- Primary care physicians; Alzheimer's disease -- Periodicals; Alzheimer's disease -- Diagnosis -- Periodicals; Dementia -- Periodicals; Dementia -- Diagnosis -- Periodicals; 616.831
• DOI: 10.1016/j.dadm.2015.06.009
• Languages: English
• ISSNs: 2352-8729

Abstract

Abstract: Introduction: This study investigated whether neuropsychological testing in primary care (PC) offices altered physician‐initiated interventions related to cognitive impairment (CI) or slowed the rate of CI progression. Methods: This 24‐month, cluster‐randomized study included 11 community‐based PC practices randomized to either treatment as usual (5 practices) or cognitive report (CR; 6 practices) arms. From 2005 to 2008, 533 patients aged ≥65 years and without a diagnosis of CI were recruited; 423 were retested 24 months after baseline. Results: CR physicians were significantly more likely to order cognitive‐related interventions ( P = .02), document discussions about cognition ( P = .003), and order blood tests to rule out reversible CI ( P = .002). At follow‐up, significantly more CR patients had a medication for cognition listed in their chart ( P = .02). There was no difference in the rate of cognitive decline between the groups. Discussion: Providing cognitive information to physicians resulted in higher rates of physician‐initiated interventions for patients with CI.