Brief Cognitive Screening Tools for Primary Care Practice

Early detection and diagnosis of Alzheimer’s disease and other cognitive impairment presents as a critical issue facing primary and specialty care providers in Washington State. In order to address the gaps and challenges faced by providers, the Dementia Action Collaborative offers the current paper to provide information and guidance around early detection and diagnosis of memory loss and dementia, including Alzheimer’s disease. At the conclusion of this paper, providers should be able to identify indications and opportunities for detection, appropriate tools, and care pathways for individuals and families affected by cognitive impairment and dementia

Alzheimer’s Disease and Other Dementias Workgroup: Alzheimer’s Disease and Other Dementias Report and Recommendations

Rates of Alzheimer’s disease and other dementias are expected to increase greatly over the next decades. Many practices lack guidelines on how to increase quality of diagnosing, treating, and supporting people with dementia and their family members and other caregivers. This workgroup met from January to November 2017, aligned with and built off the Alzheimer’s State Plan, and organized recommendations with the following focus areas: Early detection and appropriate diagnosis Ongoing care and support or management including for family members and caregivers Advance care planning and palliative care Assessment and planning for need for increased support and/or higher levels of care Preparing for potential hospitalization Screening for delirium risk during hospitalization for all patients over 6

Tips for Healthy Aging: A Conversation About Dementia with Dr. Nancy Isenberg

Nancy Isenberg, M.D., MPH, is a neurologist at Swedish Edmonds who cares for patients with Alzheimer’s disease and other forms of dementia. She is the medical director of the Center for Healthy Aging, where patients and their families receive comprehensive care that goes beyond treating dementia to address the emotional, physical and social challenges that come with it. June is Alzheimer’s & Brain Awareness Month, so we called her up to find out what you need to know about the disease, what makes her approach to care different and what you can do to keep your brain sharp

Chapter: Cognitive Neurology

Dementia, Parkinson\u27s Disease, headache, and neuropathy are all conditions for which narrowly focused medical interventions all too often fall short. The first book in its field, Integrative Neurology synthesizes complementary modalities with state-of-the-art medical treatment to offer a new vision for neurological care. The authors begin by looking inward at the crisis of stress and burnout that confronts all of medicine, but neurology in particular. It goes on to provide a selective yet in-depth review of important topics in neurological practice from the perspective of integrative medicine. Taking an evidence based approach throughout, chapters cover chronic diseases such as Multiple Sclerosis, Dementia, and Parkinson\u27s Disease. The volume also address clinical issues such as headache, traumatic brain injury, navigating the endocannabinoid system and aging, nutrition and stroke, neuropathy, toxins and neurodevelopment, as well as the modalities of Ayurvedic Medicine and acupuncture.Integrative medicine is defined as a healing-oriented medicine that takes account of the whole person (body, mind, and spirit) as well as all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of appropriate therapies, both conventional and alternative. Series editor Andrew Weil, MD is Professor and Director of the Arizona Center for Integrative Medicine at the University of Arizona. Dr. Weil\u27s program was the first such academic program in the US, and its stated goal is to combine the best ideas and practice of conventional and alternative medicine into cost effective treatments without embracing alternative practices uncritically

Resilience and Dementia

Interview with leading neuroscientist, Dr. Nancy Isenber

Facebook Live: Compassionate Care for Elderly Patients in the Era of COVID-19

Please join us for a live discussion focused on compassionate care for the elderly during the pandemic, and what it means for patients, their families, and their community of caregivers

The aging brain: risk factors and interventions for long term brain health in women.

PURPOSE OF REVIEW: Poor cognitive aging and dementia pose a significant public health burden, and women face unique risks compared to men. Recent research highlights the role of genetics, menopause, chronic disease, and lifestyle in risk and resilience in women\u27s cognitive aging. This work suggests avenues for clinical action at midlife that may change the course of brain health in aging. RECENT FINDINGS: Studies indicate women\u27s risk for poor cognitive aging relates in part to hormone changes at menopause, a time when memory, brain structure and function, and Alzheimer\u27s pathology may be observed in women and not men. Medical and lifestyle risks including diabetes, hypertension, and low physical activity also contribute to women\u27s unique risks. At the same time, literature on resilience suggests women may benefit from lifestyle and chronic disease intervention, possibly more than men. Current studies emphasize the importance of interacting genetic and lifestyle risks, and effects of social determinants of health. SUMMARY: Women have greater risk than men for poor cognitive aging; however, by treating the whole person, including genetics, lifestyle, and social environment, clinicians have an opportunity to support healthy cognitive aging in women and reduce the future public health burden of dementia

UW Project ECHO-Dementia: Implementation of a virtual clinic and telementoring program to improve dementia diagnosis and treatment in rural and under-resourced primary care settings.

BACKGROUND: Primary care providers are on the front lines of dementia care and frequently the first point of contact for individuals and families concerned about changes in memory and thinking. In addition to the challenges of managing complex medical comorbidities, primary care providers in rural or lower-resource settings often lack access to specialists, interdisciplinary teams or other programs and services to aid in diagnosis and care of individuals with mild cognitive impairment and dementia. The current project extends an existing technology-based hub and spoke model virtual clinic, Project ECHO (Extension for Community Healthcare Outcomes, University of New Mexico), to improve diagnosis and care of dementia in primary care. METHOD: The current project is an extension of work related to the Washington State Plan for Alzheimer\u27s Disease and Other Dementias with implementation supported by legislative funding. The program includes an interdisciplinary expert panel ( hub ) meeting with participants ( spokes ) including primary and allied health care providers from healthcare systems, group practices, and solo practitioners. The twice-monthly virtual clinic sessions include a brief didactic followed by case-based learning in an all-teach, all-learn format emphasizing expertise and experience of spoke sites as well as the hub. Participants are provided with resources discussed during the clinic session, ongoing opportunities for consultation, and free continuing education credits. RESULTS: Launching amid the COVID-19 pandemic, the program has provided over 250 hours of education to more than 50 providers across 20 unique sites. Post session surveys indicate that the program is well-received with 2 in 3 providers indicating that they will change their practice based on learning. Surveys also demonstrate significant increases in both knowledge and confidence in dementia-specific diagnosis and care. CONCLUSION: The success of the current project demonstrates both the feasibility and benefit of leveraging technology to deliver dementia-related education to primary care providers in rural and under-resourced settings. While initially hampered by disruptions in care due to the COVID-19 pandemic, increased technological proficiency on the provider and systems level has appeared to be a benefit in terms of resources and comfort participating in a virtual education program to scale Dementia Capable Care in Primary Care