title: Cognitive testing in older primary care patients: A cluster-randomized trial.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  Providing cognitive information to physicians resulted in higher rates of physician-initiated interventions for patients with CI.
authors.affiliation: Department of Medicine, School of Medicine, Regenstrief Institute, Indiana University, Indianapolis, IN, USA.
authors.forename: Nicole R
authors.initials: NR
authors.lastname: Fowler
authors.affiliation: Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Morrow
authors.affiliation: School of Education, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Laurel
authors.initials: L
authors.lastname: Chiappetta
authors.affiliation: Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Snitz
authors.affiliation: Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Huber
authors.affiliation: Department of Medicine, School of Medicine, Regenstrief Institute, Indiana University, Indianapolis, IN, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Rodriguez
authors.affiliation: Department of Medicine, School of Medicine, Regenstrief Institute, Indiana University, Indianapolis, IN, USA ; Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Saxton
keywords: Age; Alzheimer's disease; Cognitive impairment; Community-based; Dementia; Mild cognitive impairment primary care; Primary care physicians