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Detection of Cognitive Impairment in Primary Care

Primary care doctors are the first line of defense against all disease, charged with the responsibility of recognizing and diagnosing all disorders, including neurologic conditions.  In fact, due to the growing shortage of neurologists, primary care doctors currently care for approximately 75% of all neurologic patients.  Unfortunately, all evidence to date suggests that primary care doctors are often late in detecting cognitive impairment.

A recent study of almost 230,000 primary care doctors showed they detected only 8% of estimated cases of mild cognitive impairment (MCI), the precursor to Alzheimer’s disease in 50% of cases.  This woeful delay in detection of early dementia results in delayed treatment and/or referral for treatment which ultimately results in poor clinical outcomes. 

There are many possible reasons for the delay. Some studies show that primary care doctors may be uncomfortable asking about dementia and families often do not mention it unless asked.  At the earliest stages of MCI the signs may be subtle and not obvious even to the patient or her family.  In fact, making the diagnosis requires education and training not often emphasized in primary care training. Further, primary care doctors are under pressure to see more and more patients each day, leaving little time to address all the medical conditions the elderly patients may have. Even if MCI is suspected, making a referral to see a dementia specialist is difficult and takes a great deal of time. Finally, until recently, little could be done to help slow down or reverse progression, making the establishment of a diagnosis less compelling.

With the releases of new therapies for dementia, including the anti-amyloid agents, it is more important than ever to diagnosis cognitive decline as earlier as possible.  The earlier the diagnosis is made, the better the clinical outcome is likely to be.  BeCare Neuro Link can help both you and your physician screen for cognitive impairment or other neurologic disease and can help you track your cognition if you do receive the diagnosis.  Through subscribing to BeCare Neuro Link you can print out a written interpretation of your cognitive performance or email to your doctor. BeCare Neuro Link can help you become an active force in your or your loved one’s cognitive health.


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