More than one third of patients aged 65 years and older are routinely accompanied by a family member, close friend, or neighbor to their primary care visits; these older individuals, on average, are sicker and more likely to have dementia than those who are not routinely accompanied to their primary care visits (Wolff, 2008).
Family members and others may offer valuable insights about a person’s cognition-related behaviors such as (U.S. Department of Veterans Affairs, 2020):
During the visit, health care team members may turn to the family member, friend, or neighbor and ask, “Have you noticed changes in your relative’s (or friend’s) memory?”
Some family members and friends may be reluctant to talk about such changes in front of the individual because they do not want to upset or embarrass their friend or relative. For this reason, when speaking with a family member, close friend, or neighbor about the individual’s cognition, consider asking the patient, “Do you mind if I ask your [family member, friend, neighbor] about your memory?”
In follow-up visits, a validated questionnaire can be completed by family members and other knowledgeable informants (as described in Assess). The results of the questionnaire can be used to help determine whether a diagnostic evaluation is needed.
Michael Hornbecker, MD, US Fellowship Lead, Davos Alzheimer’s Collaborative Healthcare System Preparedness
Conversations about brain health can begin in many different ways, but usually they begin after a medical assistant has performed a cognitive screening. Also, many of my patients raise concerns about their memory. I ask them to describe their concerns to me and give me examples of what sorts of incidents are causing the concerns. If the results of the cognitive screening were abnormal, I would begin the conversation by asking if they have any concerns about their memory. Additionally, I may ask a care partner, if present, and the patient consents, about the cognitive concerns.
Overview | Discuss Brain Health | Engage in Conversations About Protective Actions | Address Diverse Life Experiences | Discuss Memory and Cognition | Observe for Signs and Symptoms of Cognitive Impairment | Listen for Patient and Family Concerns About Cognition | Address Any Sensory Loss and Use Effective Communication Strategies | Use Health Questionnaires | Use Electronic Health Records | Primary Prevention Recommendations for Reducing Risk of Cognitive Decline | Warning Signs That Might Indicate Dementia | Resources for Patients About Brain Health | Kickstart References