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Dementia - American Family Physician

Jun 15, 2020 - This collection features AFP content on dementia and related issues, including Alzheimer’s, Binswanger’s type, dementia, and dementia with Lewy bodies. This collection features AFP content on dementia and related issues, including Alzheimer’s, Binswanger’s type, dementia, and dementia ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=5

Neuropsychological Evaluations in Adults - American Family Physician

Jan 15, 2019 - Neuropsychologists provide detailed assessments of cognitive and emotional functioning that often cannot be obtained through other diagnostic means. They use standardized assessment tools and integrate the findings with other data to determine whether cognitive decline has occurred, to ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p101.html

Evaluation of Suspected Dementia - American Family Physician

Mar 15, 2018 - Dementia is a significant and costly health condition that affects 5 million adults and is the fifth leading cause of death among Americans older than 65 years. The prevalence of dementia will likely increase in the future because the number of Americans older than 65 years is expected ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p398.html

Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and ...

Jun 15, 2017 - Alzheimer disease comprises a syndrome of progressive cognitive and functional decline. Treatments should target cognitive and functional symptoms. Cholinesterase inhibitors, memantine, and a combination of a cholinesterase inhibitor and memantine have produced statistically significant...

American Family Physician : Article

https://www.aafp.org/afp/2017/0615/p771.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Evaluation of Suspected Dementia - American Family Physician

Oct 15, 2011 - As the proportion of persons in the United States older than 65 years increases, the prevalence of dementia will increase as well. Risk factors for dementia include age, family history of dementia, apolipoprotein E4 genotype, cardiovascular comorbidities, chronic anticholinergic use, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1015/p895.html

Treatment of Alzheimer Disease - American Family Physician

Jun 15, 2011 - Alzheimer disease is the most common form of dementia, affecting more than one-third of Americans older than 85 years. It is characterized by progressive memory loss and cognitive decline. Amyloid plaque accumulation, neurofibrillary tau tangles, and depletion of acetylcholine are among...

American Family Physician : Article

https://www.aafp.org/afp/2011/0615/p1403.html

Screening for Cognitive Impairment in Older Adults: Recommendation Statement - U.S. ...

Jun 15, 2020 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment in older adults.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2020/0615/od1.html

Some Drugs Slightly Improve Cognition in People with Dementia; Effects on Behavioral or... Restricted content. Login required.

Dec 1, 2020 - Some treatments can improve cognition on research scales, but daily function will not be affected in a noticeable way. Managing behavioral or psychological issues with medication is not supported by current evidence

American Family Physician : POEMs

https://www.aafp.org/afp/2020/1201/p694.html

Screening for Cognitive Impairment in Older Adults - Putting Prevention into Practice -... Restricted content. Login required.

Jun 15, 2020 - L.C. is a 70-year-old Asian American woman who retired from teaching middle school five years ago. She lives independently and has a daughter and grandchildren who live within 30 miles of her. She presents for a follow-up visit to renew her hypertension medications. Her blood pressure ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0615/p753.html

Frontotemporal Dementia: A Review for Primary Care Physicians - American Family Physician

Dec 1, 2010 - Frontotemporal dementia (FTD) is one of the most common forms of dementia in persons younger than 65 years. Variants include behavioral variant FTD, semantic dementia, and progressive nonfluent aphasia. Behavioral and language manifestations are core features of FTD, and patients have ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1201/p1372.html

Nonpharmacologic Approaches Are Better Than Medication to Control Aggression and ... Restricted content. Login required.

May 15, 2020 - Nonpharmacologic approaches to agitation or aggression in patients with dementia are more effective than medication (e.g., haloperidol). Outdoor activities, multidisciplinary care, and massage and touch therapy with or without music are all effective.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p631a.html

Vitamin and Mineral Supplementation for Maintaining Cognitive Functioning in ... Restricted content. Login required.

Mar 1, 2020 - Vitamin and mineral supplementation has little to no beneficial effect on preserving cognitive functioning or preventing dementia in cognitively healthy adults 40 years and older.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0301/p272.html

Diagnosing Dementia and Clarifying Goals of Care - Lown Right Care: Reducing Overuse ...

Sep 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/0915/p369.html

Palliative Care in Advanced Dementia - Curbside Consultation - American Family Physician

Apr 1, 2019 - What is the best way for family physicians to determine prognosis and applicability of palliative care for patients with dementia?

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0401/p456.html

Vitamin D is Equal to Placebo for Preventing Cognitive Decline in African-American ...

Jul 15, 2019 - Is vitamin D more effective than placebo in preventing cognitive decline in African American women older than 65 years who have low serum vitamin D levels at baseline?

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118.html

Vitamin B12 Deficiency - American Family Physician

Mar 1, 2003 - Vitamin B12 (cobalamin) deficiency is a common cause of macrocytic anemia and has been implicated in a spectrum of neuropsychiatric disorders. The role of B12 deficiency in hyperhomocysteinemia and the promotion of atherosclerosis is only now being explored. Diagnosis of vitamin B12 ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0301/p979.html

Behavior Disorders of Dementia: Recognition and Treatment - American Family Physician

Feb 15, 2006 - Psychosis may pose a greater challenge than cognitive decline for patients with dementia and their caregivers. The nature and frequency of psychotic symptoms varies over the course of illness, but in most patients, these symptoms occur more often in the later stages of disease. ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0215/p647.html

Pharmacologic Interventions for Apathy in Patients with Alzheimer Disease - Cochrane ...

Jan 1, 2019 - Methylphenidate may improve apathy in select patients with AD (mean difference [MD] = –4.99 on the apathy evaluation scale; 95% confidence interval [CI], –9.55 to –0.43), although the clinical significance associated with these findings remains unclear and the evidence is considered low...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0101/p14.html

Deprescribing Antipsychotics for Behavioral and Psychological Symptoms of Dementia and ...

Sep 15, 2018 - As part of the Deprescribing Guidelines in the Elderly Project, a Canadian team consisting of two family physicians, one geriatric psychiatrist, two geriatricians, and four pharmacists has provided recommendations to guide physicians in deprescribing antipsychotics for behavioral and ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0915/p394.html

Cerebrospinal Fluid Biomarkers for Detection of Alzheimer Disease in Patients with Mild...

Jun 1, 2018 - There is insufficient evidence to support the routine use of cerebrospinal fluid (CSF) biomarkers for the detection of progressive dementias in patients with mild cognitive impairment (MCI). These tests carry the risk of overdiagnosis of dementia and, therefore, overtreatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0601/p714.html

Medications Ineffective to Prevent Cognitive Decline or Dementia - POEMs - American ...

Aug 15, 2018 - None of the medications in this systematic review prevented or delayed cognitive decline, cognitive impairment, or dementia.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p248a.html

Short-Term Antipsychotics for Alzheimer Disease - FPIN's Help Desk Answers - American ...

Apr 1, 2018 - Physicians should consider not using antipsychotics in patients with dementia. Patients with dementia, including Alzheimer disease, who are treated with antipsychotics for any length of time have a higher mortality rate than those not taking antipsychotics.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0401/od2.html

Light Therapy Improves Behavioral Disturbances, Sleep, Depression in Older Patients ...

Feb 15, 2018 - In this meta-analysis, older patients with cognitive impairment who were exposed to light therapy had moderate improvements in behavioral disturbances, small improvements in sleep quality, and moderate improvements in depression. The authors did not report data on responders vs. ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od2.html

The AAFP Cognitive Care Kit: A Resource for Family Physicians - Editorials - American ...

Nov 15, 2017 - The AAFP Cognitive Care Kit was designed to give primary care physicians access to recommended materials to identify, screen, care for, and educate patients with cognitive impairment, as well as assist caregivers.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/1115/p630.html

Mini-Mental State Examination for the Detection of Dementia in Older Patients - ...

Dec 1, 2016 - When scores are adjusted based on a patient's education level, the MMSE may be useful to rule out a diagnosis of dementia in clinically unevaluated patients 65 years and older (sensitivity = 97%; specificity = 70%). Scores of less than 24 may also be useful to rule in dementia in ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1201/p880.html

Dementia Care: More Than Just Prescription Drugs - Editorials - American Family Physician

Jun 15, 2017 - Rather than focusing on medications to achieve a small temporary difference in cognition, patients and families might be better served if we focused more on nonpharmacologic treatments, and on more important issues, such as advance directives, driving, living arrangements, caregiver ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0615/p766.html

Alzheimer Disease: Monotherapy vs. Combination Therapy - FPIN's Help Desk Answers - ...

Apr 1, 2017 - Combination treatment with memantine and donepezil results in a small improvement in cognitive function that is of uncertain clinical significance in patients with moderate to severe Alzheimer disease, but no improvement in patients with mild to moderate disease.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0401/p452.html

The Effect of Statins on Dementia and Cognitive Decline - Cochrane for Clinicians - ...

Feb 1, 2017 - Statins given in later life to patients at risk of vascular disease do not prevent dementia or cognitive decline compared with placebo. Adverse effects are similar between groups.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0201/p151.html

Exercise to Improve Functioning in Patients with Dementia - FPIN's Help Desk Answers - ...

Aug 1, 2016 - Exercise programs lasting at least two months moderately increase the ability of patients with dementia to perform ADLs.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0801/p242.html

Dementia With Lewy Bodies: An Emerging Disease - American Family Physician

Apr 1, 2006 - Dementia with Lewy bodies appears to be the second most common form of dementia, accounting for about one in five cases. The condition is characterized by dementia accompanied by delirium, visual hallucinations, and parkinsonism. Other common symptoms include syncope, falls, sleep ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0401/p1223.html

Use of Atypical Antipsychotics in Patients with Dementia - American Family Physician

Jun 1, 2003 - Increasingly, atypical antipsychotic drugs are prescribed for elderly patients with symptoms of psychosis and behavioral disturbances. These symptoms often occur in patients with Alzheimer's disease, other dementias, or Parkinson's disease. As the average age of Americans increases, the...

American Family Physician : Article

https://www.aafp.org/afp/2003/0601/p2335.html

Screening for Cognitive Impairment in Older Adults - Putting Prevention into Practice -...

Jul 15, 2015 - N.D. is a 72-year-old white man who presents for a preventive visit. He smokes, and his medical history is significant for essential hypertension, which is stable and well controlled with medication. N.D.'s close friend was recently diagnosed with dementia, and N.D. is concerned that he...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2015/0715/p125.html

Screening for Cognitive Impairment in Older Adults: Recommendation Statement - U.S. ...

Mar 15, 2015 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2015/0315/od2.html

Initial Evaluation of the Patient with Suspected Dementia - American Family Physician

May 1, 2005 - Dementia is a common disorder among older persons, and projections indicate that the number of patients with dementia in the United States will continue to grow. Alzheimer's disease and vascular dementia account for the majority of cases of dementia. After a thorough history and ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0501/p1745.html

Benzodiazepines and Alzheimer Disease - AFP Journal Club - American Family Physician

Feb 1, 2015 - Benzodiazepine exposure over the preceding five years seems to be associated with an increased likelihood of an Alzheimer disease diagnosis. A dose-response gradient also seems to exist.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2015/0201/p191.html

Management of Normal Pressure Hydrocephalus - American Family Physician

Sep 15, 2004 - Gait instability, urinary incontinence, and dementia are the signs and symptoms typically found in patients who have normal pressure hydrocephalus. Estimated to cause no more than 5 percent of cases of dementia, normal pressure hydrocephalus often is treatable, and accurate recognition ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0915/p1071.html

Early Diagnosis of Dementia - American Family Physician

Feb 15, 2001 - Until recently, the most significant issue facing a family physician regarding the diagnosis and treatment of dementia was ruling out delirium and potentially treatable etiologies. However, as more treatment options become available, it will become increasingly important to diagnose ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0215/p703.html

Exercise Programs for Older Patients with Dementia - Cochrane for Clinicians - American...

Sep 1, 2014 - There is some evidence that exercise improves cognitive function and the ability to perform activities of daily living in patients with dementia.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/0901/p287.html

Efficient Identification of Adults with Depression and Dementia - American Family ...

Sep 15, 2004 - Family physicians must decide how to screen for depression or dementia and which patients to screen. Mental health questionnaires can be helpful. In practice-based screening, questionnaires are administered to all patients, regardless of risk status. In case-finding screening, ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0915/p1101.html

Should Family Physicians Routinely Screen Patients for Cognitive Impairment? Yes: ...

Jun 1, 2014 - Being able to anticipate and mitigate the potentially adverse outcomes of hospitalization in these patients should be reason enough to screen for cognitive impairment in the primary care setting.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2014/0601/p861.html

Should Family Physicians Routinely Screen Patients for Cognitive Impairment? No: ...

Jun 1, 2014 - Dementia screening should not be exempt from the requirement that it first be shown to improve outcomes before being implemented in practice.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2014/0601/p864.html

Dementia - Clinical Evidence Handbook - American Family Physician

Jan 15, 2014 - What are the effects of treatments on cognitive, behavioral, and psychological symptoms of dementia (Alzheimer disease, Lewy body dementia, or vascular dementia)?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2014/0115/p117.html

Feeding Tubes in Patients with Severe Dementia - American Family Physician

Apr 15, 2002 - Patients with advanced dementia are among the most challenging patients to care for because they are often bedridden and dependent in all activities of daily living. Difficulty with eating is especially prominent and distresses family members and health care professionals. Health care ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0415/p1605.html

Pharmacologic Treatment of Alzheimer's Disease: An Update - American Family Physician

Oct 1, 2003 - Alzheimer's disease is characterized by the development of senile plaques and neurofibrillary tangles, which are associated with neuronal destruction, particularly in cholinergic neurons. Drugs that inhibit the degradation of acetylcholine within synapses are the mainstay of therapy. ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1001/p1365.html

Guidelines for Managing Alzheimer's Disease: Part II. Treatment - American Family ...

Jun 15, 2002 - Once the clinical diagnosis of Alzheimer's disease has been made, a treatment plan must be developed. This plan should include cholinesterase inhibitor therapy to temporarily improve cognition or slow the rate of cognitive decline, management of comorbid conditions, treatment of ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0615/p2525.html

Antidepressants for Agitation and Psychosis in Patients with Dementia - Cochrane for ...

Jan 1, 2012 - There are few high-quality studies examining the effectiveness of antidepressants for treating the neuropsychiatric symptoms of dementia. Although there is some evidence to support the use of the selective serotonin reuptake inhibitors (SSRIs) sertraline (Zoloft) and citalopram ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/0101/p20.html

Guidelines for Managing Alzheimer's Disease: Part I. Assessment - American Family ...

Jun 1, 2002 - Family physicians play a key role in assessing and managing patients with Alzheimer's disease and in linking the families of these patients to supportive services within the community. As part of comprehensive management, the family physician may be responsible for coordinating ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0601/p2263.html

Cognitive Interventions for Improving Cognitive Function - Cochrane for Clinicians - ...

Nov 1, 2011 - Compared with no treatment, cognitive interventions improved cognitive performance in healthy older adults and older adults with mild cognitive impairments. However, there is inadequate evidence to determine which aspects of these interventions are effective.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2011/1101/p992.html

Advances in the Treatment of Alzheimer's Disease - American Family Physician

Nov 1, 1998 - Management of the most common type of dementia--Alzheimer's disease--is becoming increasingly sophisticated. Differentiation of Alzheimer's disease from vascular dementia has become therapeutically important, since the choice of treatments depends on the diagnosis. Two cholinesterase ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1101/p1577.html

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