Alzheimer's disease: issues and challenges in primary care.
The challenge in primary care practice is identifying persons with symptoms of Alzheimer's Disease (AD) who often have limited capacity to recognize their own symptoms and attribute cognitive decline to chronic illness or aging. Brief office visit communications without an informant,such as a spouse or adult child rarely uncover mild stage AD. Clinicians in primary care fail to screen older adults for AD on a routine basis be-cause of insufficient time, inadequate reimbursement for services, and uncertainty about the value of an early diagnosis. Although current pharmacologic and behavioral interventions and patient education do not prevent eventual disease progression, they arguably lead to improvements in understanding, self-efficacy, and quality of life for the patient and family.
Cotter
Valerie T
VT
School of Nursing, 420 Guardian Drive, University of Pennsylvania, Philadelphia, PA 19104, USA. cottervt@nursing.upenn.edu
D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D017028:Caregivers / Q000193:education / Q000523:psychology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D018450:Disease Progression; D005190:Family / Q000523:psychology; D015577:Geriatric Assessment; D005851:Geriatric Nursing; D006801:Humans; D008403:Mass Screening; D016202:N-Methylaspartate / Q000037:antagonists & inhibitors; D009483:Neuropsychological Tests; D024802:Nurse's Role; D009730:Nursing Assessment; D009819:Office Visits; D010353:Patient Education as Topic; D011320:Primary Health Care / Q000458:organization & administration*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D020377:Self Efficacy; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology
D002800:Cholinesterase Inhibitors; D016202:N-Methylaspartate