Risk Factors for Mild Cognitive Impairment in German Primary Care Practices

2017 ◽  
Vol 56 (1) ◽  
pp. 379-384 ◽  
Author(s):  
Louis Jacob ◽  
Jens Bohlken ◽  
Karel Kostev
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Care Practices ◽  
Primary Care Practices

scholarly journals Risk Factors For Dementia Diagnosis In German Primary Care Practices

2015 ◽  
Vol 18 (7) ◽  
pp. A406
Author(s):  
A Wendschlag ◽  
L Jacob ◽  
K Kostev ◽  
J Bohlken ◽  
MA Rapp
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Dementia Diagnosis ◽  
Care Practices ◽  
Primary Care Practices

scholarly journals Diabetes mellitus in dogs attending UK primary-care practices: frequency, risk factors and survival

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Angela M. Heeley ◽  
Dan G. O’Neill ◽  
Lucy J. Davison ◽  
David B. Church ◽  
Ellie K. Corless ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Primary Care ◽  
Care Practices ◽  
Primary Care Practices

scholarly journals Geriatric Resource Teams: Equipping Primary Care Practices to Meet the Complex Care Needs of Older Adults

Geriatrics ◽  
2019 ◽  
Vol 4 (4) ◽  
pp. 59 ◽  
Author(s):  
Gwendolen Buhr ◽  
Carrissa Dixon ◽  
Jan Dillard ◽  
Elissa Nickolopoulos ◽  
Lynn Bowlby ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Assessment Process ◽  
Complex Care ◽  
Care Needs ◽  
Care Practices ◽  
Primary Care Practices ◽  
Complex Care Needs ◽  
The Impact

Primary care practices lack the time, expertise, and resources to perform traditional comprehensive geriatric assessment. In particular, they need methods to improve their capacity to identify and care for older adults with complex care needs, such as cognitive impairment. As the US population ages, discovering strategies to address these complex care needs within primary care are urgently needed. This article describes the development of an innovative, team-based model to improve the diagnosis and care of older adults with cognitive impairment in primary care practices. This model was developed through a mentoring process from a team with expertise in geriatrics and quality improvement. Refinement of the existing assessment process performed during routine care allowed patients with cognitive impairment to be identified. The practice team then used a collaborative workflow to connect patients with appropriate community resources. Utilization of these processes led to reduced referrals to the geriatrics specialty clinic, fewer patients presenting in a crisis to the social worker, and greater collaboration and self-efficacy for care of those with cognitive impairment within the practice. Although the model was initially developed to address cognitive impairment, the impact has been applied more broadly to improve the care of older adults with multimorbidity.

scholarly journals Comparison of Cardiovascular Risk Screening Methods and Mortality Data Among Hungarian Primary care Population: Preliminary Results of the First Government-Financed Managed care Program / Primerjava Metod Presejanja Ogroženosti Srčno-Žilnega Sistema In Podatkov O Smrtnosti Madžarskega Prebivalstva Z Osnovno Zdravstveno Oskrbo: Predhodni Rezultati Prvega Programa Vodene Oskrbe, Ki Ga Je Financirala Vlada

2015 ◽  
Vol 54 (3) ◽  
pp. 154-160
Author(s):  
Csaba Móczár ◽  
Imre Rurik
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Managed Care ◽  
Screening Method ◽  
Care Program ◽  
Average Score ◽  
Mortality Data ◽  
Screening Methods ◽  
Care Practices ◽  
Primary Care Practices

Abstract Introduction. Besides participation in the primary prevention, screening as secondary prevention is an important requirement for primary care services. The effect of this work is influenced by the characteristics of individual primary care practices and doctors’ screening habits, as well as by the regulation of screening processes and available financial resources. Between 1999 and 2009, a managed care program was introduced and carried out in Hungary, financed by the government. This financial support and motivation gave the opportunity to increase the number of screenings. Method. 4,462 patients of 40 primary care practices were screened on the basis of SCORE risk assessment. The results of the screening were compared on the basis of two groups of patients, namely: those who had been pre-screened (pre-screening method) for known risk factors in their medical history (smoking, BMI, age, family cardiovascular history), and those randomly screened. The authors also compared the mortality data of participating primary care practices with the regional and national data. Results. The average score was significantly higher in the pre-screened group of patients, regardless of whether the risk factors were considered one by one or in combination. Mortality was significantly lower in the participating primary practices than had been expected on the basis of the national mortality data. Conclusion. This government-financed program was a big step forward to establish a proper screening method within Hungarian primary care. Performing cardiovascular screening of a selected target group is presumably more appropriate than screening within a randomly selected population. Both methods resulted in a visible improvement in regional mortality data, though it is very likely that with pre-screening a more cost-effective selection for screening may be obtained.

scholarly journals Risk of developing dementia in people with diabetes and mild cognitive impairment

2010 ◽  
Vol 196 (1) ◽  
pp. 36-40 ◽  
Author(s):  
Latha Velayudhan ◽  
Michaela Poppe ◽  
Nicola Archer ◽  
Petroula Proitsi ◽  
Richard G. Brown ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Sociodemographic Factors ◽  
Self Report ◽  
Health Conditions ◽  
Community Based ◽  
Risk Of Progression ◽  
Care Practices ◽  
Primary Care Practices

BackgroundDiabetes mellitus is associated with cognitive dysfunction, but it is not clear whether the disorder increases the risk of conversion from mild cognitive impairment to dementia.AimsTo determine the association between diabetes mellitus and dementia conversion in people with mild cognitive impairment (Peterson's criteria) in a prospective community-based study.MethodPeople over 65 years old were approached through primary care practices in south London, UK, and those with mild cognitive impairment (n = 103) were followed up for 4 years. Presence of diabetes was established from self-report and information from general practitioners.ResultsNineteen participants progressed to dementia, with the predominant diagnosis being probable or possible Alzheimer's disease (in 84%). Only diabetes mellitus was associated with progression to dementia (hazard ratio 2.9, 95% CI 1.1–7.3) after adjustment for sociodemographic factors, APOE4, premorbid IQ and other health conditions.ConclusionsDiabetes mellitus increases not only the risks of dementia and mild cognitive impairment but also the risk of progression from such impairment to dementia.

scholarly journals Assessing Quality Improvement Capacity in Primary Care Practices

2019 ◽  
Author(s):  
Michael Parchman ◽  
Melissa L. Anderson ◽  
Katie F Coleman ◽  
LeAnn Michaels ◽  
Linnaea Schuttner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Primary Care ◽  
Quality Improvement ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Prior Experience ◽  
Pressure Control ◽  
Care Practices ◽  
Primary Care Practices

Abstract Background: Healthy Hearts Northwest (H2N) is a study of external support strategies to build quality improvement (QI) capacity in primary care with a focus on cardiovascular risk factors: appropriate aspirin use, blood pressure control, and tobacco screening/cessation. Methods: To guide practice facilitator support, experts in practice transformation identified seven domains of QI capacity and mapped items from a previously validated medical home assessment tool to them. A practice facilitator (PF) met with clinicians and staff in each practice to discuss each item on the Quality Improvement Capacity Assessment (QICA) resulting in a practice-level response to each item. We examined the association between the QICA total and sub-scale scores, practice characteristics, a measure of prior experience with managing practice change, and performance on clinical quality measures (CQMs) for the three cardiovascular risk factors. Results: The QICA score was associated with prior experience managing change and moderately associated with two of the three CQMs: aspirin use (r=0.16, p=0.049) and blood pressure control (r=0.18, p=0.013). Rural practices and those with 2-5 clinicians had lower QICA scores. PFs notes provide examples of high scoring practices devoting time and attention to quality improvement whereas low scoring practices did not. Conclusions: The QICA is useful for assessing QI capacity within a practice and may serve as a guide for both facilitators and primary care practices in efforts to build this capacity and improve measures of clinical quality.

scholarly journals FEASIBILITY AND ACCEPTABILITY OF DETECTING COGNITIVE IMPAIRMENT AND DEMENTIA IN PRIMARY CARE PRACTICES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S782-S782
Author(s):  
Rachel O’Conor ◽  
Julia Yoshino Benavente ◽  
Laura Curtis ◽  
Marina Arvanitis ◽  
Richard Gershon ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Case Finding ◽  
The Us ◽  
Administrative Leaders ◽  
Care Practices ◽  
Primary Care Practices ◽  
And Storage

Abstract As the age of the US population increases, so does cognitive impairment (CI); therefore early detection of CI is critical for ensuring its appropriate management. As part of a NINDS Consortium to detect CI and dementia in primary care (DetectCID), we are implementing and evaluating a brief 2-step CI detection paradigm (MyCog), that can be delivered in clinics with diverse populations via the electronic health record (step 1) and iPad (step 2). We conducted focus groups with 25 clinicians and administrative leaders from academic and community primary care practices to 1) understand how CI is being assessed, and 2) evaluate the feasibility of implementing the MyCog paradigm into existing primary care workflows. Several key themes emerged from the discussions. No proactive detection strategy for CI was regularly used outside of the Medicare Annual Wellness Visits (AWV); variable assessments including the Minicog, MoCA, or MMSE were used to fulfill the AWV requirement. Regarding the feasibility of our MyCog Paradigm, our 2-step process was positively received, with the brief case-finding step 1 satisfying AWV requirements and replacing the longer assessments currently being used. Clinicians preferred that step 2 be self-administered due to limited clinician time for wellness visits, and highlighted logistical challenges such as room availability and storage and maintenance of the iPad. Overall, clinicians felt that the identification of CI was valuable and supported standardization, but indicated regular case finding was unlikely without clear guidance on clinical decision-making.

scholarly journals Acanthosis Nigricans and Diabetes Risk Factors: Prevalence in Young Persons Seen in Southwestern US Primary Care Practices

2007 ◽  
Vol 5 (3) ◽  
pp. 202-208 ◽  
Author(s):  
A. S. Kong ◽  
R. L. Williams ◽  
M. Smith ◽  
A. L. Sussman ◽  
B. Skipper ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Acanthosis Nigricans ◽  
Diabetes Risk ◽  
Diabetes Risk Factors ◽  
Care Practices ◽  
Primary Care Practices
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