Cognitive testing in older primary care patients: A cluster‐randomized trial

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.

Keywords

• Age
• Alzheimer's disease
• Community‐based
• Cognitive impairment
• Dementia
• Mild cognitive impairment primary care