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An interdisciplinary summit developed recommendations to assist in the detection of cognitive impairment in older adults during primary care wellness visits.
An interdisciplinary Geriatrics Summit hosted by the National Academy of Neuropsychology in 2022 invited experts to develop recommendations for primary care clinicians to improve the care of older adults—particularly those experiencing a decline in cognitive abilities.
Robin C. Hilsabeck, PhD, and colleagues recently published an article in the Annals of Family Medicine that provides an overview of the recommendations developed at this summit. Dr. Hilsabeck spoke with Physician’s Weekly (PW) about issues addressed at this meeting.
PW: Why is early detection of cognitive impairment so crucial in the primary care setting?
Dr. Hilsabeck: The sooner cognitive difficulties are detected and the cause identified, the sooner appropriate treatments can be applied, and further decline can be prevented. For example, reversible causes, such as depression, stress, sleep apnea, UTIs, and polypharmacy, can be completely reversed in a small percentage of people; in a larger percentage, treatment can slow progression. Changing behaviors and managing chronic medical conditions like these can slow and sometimes prevent additional decline.
Patients and families want to learn more about the disease. Patients want to know what can be done to lessen the burden on their families, and families want to know how they can take the best care of their loved ones. Early detection allows patients and family members to take safety measures for driving, fall prevention, firearm use, cooking, etc.
Early detection can also allow patients to participate in research studies. Many patients want the chance to participate in research, which gives them meaning and purpose.
Finally, preventing and slowing progression can lower overall healthcare costs, which are staggering at the personal and societal levels.
What makes this issue particularly urgent in the current healthcare landscape?
Starting in 2030, when all baby boomers will be older than 65, older Americans will make up 21% of the population, up from 15% today. By 2060, nearly one in four Americans will be 65 years or older, the number of 85+ will triple, and the country will add a half million centenarians. With an increase in age comes an increase in cognitive impairment in older adults. Age is the number one risk factor for cognitive impairment by far. In 2024, cognitive impairment was present in approximately one out of three people aged 75 and older.
What would you like future research to focus on?
I hope researchers will develop and validate digital cognitive screening tools that can detect mild cognitive impairment and decline in culturally diverse older adults. Furthermore, it would be helpful to implement digital cognitive screening tools into primary care workflows, including integration into the electronic health record. Finally, the utility of digital cognitive screening tools combined with blood-based biomarkers for early detection of cognitive impairment and decline would positively impact this issue.
