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Study: Dementia often undiagnosed in clinical settings

PORTLAND, Ore. -- Many older patients showing signs of dementia are not being diagnosed for the progressive brain disorder by their primary care physicians, an Oregon Health & Science University study has found.

The study, published in the current issue of the Journal of Gerontology: Medical Sciences, confirms previous research that found dementia often goes undiagnosed in primary care. It points to the need for heightened awareness among primary care physicians of the cognitive functioning of older patients, especially those experiencing adverse events that may be warning signs of dementia.

While the study was conducted in the Portland-metropolitan area, its results mirror that of previous studies showing the problem is internationally pervasive.

"It is surprising how widespread the lack of dementia diagnosis is, both throughout the United States and the world," said lead author Linda Boise, Ph.D., M.P.H., assistant professor of neurology, OHSU School of Medicine, and director of education and information for the OHSU Layton Center for Aging & Alzheimer's Disease Research. Protocols for recognizing dementia symptoms exist, but "doctors just need to use them."

To study co-author Jeffrey Kaye, M.D., OHSU professor of neurology and the Layton Center's director, the results show "our hard-working primary care physicians need help. They need time to adequately address cognitive problems. And they need a reimbursement system that recognizes the value of their time taken in detecting and managing cognitive impairment in our aging population."

Researchers examined 553 patients of 34 primary care physicians affiliated with three Portland-area managed health care plans. Study subjects aged 75 and older were identified through primary care physicians to be contacted, and the study team assessed their cognitive functioning in their homes. Subjects were divided into three cognitive status groups: normal, mildly impaired and moderately-to-
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Contact: Jonathan Modie
modiej@ohsu.edu
503-494-8231
Oregon Health & Science University
15-Jul-2004


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