Cognitive Impairment in Older Adults Toolkit Project

The overall goal of the project is to provide primary care clinicians with a consensus-based, effective and practical platform of currently existing tools and evidence to screen, assess, diagnose, and effectively manage older adults with or at risk for cognitive decline and dementia.


Alzheimer’s’ disease (AD) and other dementias have become one of our major medical, public health, societal and financial issues. Early and timely recognition of cognitive decline shows clear benefits from ethical, safety and financial planning perspectives. Moreover, some cases of dementias are reversible with timely interventions and others, such as AD, disease-modifying treatment options and early management of coexisting medical conditions are shown to be beneficial.

Despite national attention to address dementia, primary care providers have made no significant improvement in recognizing dementia over the last two decades. Regrettably, there is still very little guidance for practicing clinicians to improve recognition of persons with or at risk for dementia. There is a clear need for clinicians to be prepared to recognize cognitive decline early and properly diagnose and manage dementia in older adults.

Study Description and Methods

Ten physicians were recruited to join the study’s expert panel workgroup. During the working group meeting, the expert panel assessed the perspectives of providers concerning the usefulness, completeness and acceptability of the materials provided in the context of primary care practice. A portion of the meetings focused on the discussions about the structure of the toolkit, practice workflow patterns, when and where the materials are most likely to be used.


1. To obtain, compile and review existing tools, best practices and scientific evidence related to diagnosis and treatment of cognitive impairment for the proposed toolkit.

2. To develop a practical and acceptable platform of currently existing tools and evidence to screen, assess, diagnose, and manage patients with or at risk for cognitive impairments (i.e. toolkit) in primary care setting.

3. To test the toolkit in and evaluate the degree of toolkit effects on change in provider beliefs and behaviors around early diagnosis of cognitive impairment.

4. To prepare the toolkit for dissemination: to identify different modalities and dissemination strategies for the toolkit; and determine next steps and activities to further address the need for early and improved detection of cognitive impairment in primary care based on the results of the toolkit performance evaluation and expert panel recommendations.


October 2015-December 2016


Evaluation and Dissemination

Key Findings and Publications

Tools for Better Dementia Care. Unwin BK, Loskutova N, Knicely P, Wood CD; Family Practice Management. 2019 Jan-Feb;26(1):11-16. View

The AAFP Cognitive Care Kit: A Resource for Family Physicians. Nebel KM, Loskutova NY. Am Fam Physician. 2017 Nov 15;96(10):630-631.  

AAFP FMX Expanded Learning Session September 20, 2016 View Slides(10 page PDF).

North American Primary Care Research Group (NAPCRG) Annual Meeting Poster Session November 14, 2016. View here.(1 page PDF)

Gerontological Society of America (GSA) Annual Meeting Poster Session November 18, 2016. View here(256 KB PDF).

Academy Health Dissemination and Implementation Conference Poster Session December 14-15, 2016 View here(1 page PDF).

Contact Information

For additional information about this study, please contact:

Principal Investigator
Natalia Loskutova MD PhD
Director of Evaluation
AAFP National Research Network
(800) 274-2237, ext. 6149

This study is funded by grants from Eli Lilly.