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Approach the Older Patients with Cognitive Impairment in Primary Care

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The Role of Family Physicians in Older People Care

Part of the book series: Practical Issues in Geriatrics ((PIG))

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Abstract

Forgetfulness has many reasons and even more causes. Advancing age has relative increased risks. Although loss of memory is often a prime reason of dementia, forgetfulness, and cognitive impairment, these are not synonymous terms. Cognitive impairment that includes memory, orientation, paying attention, using language, visio-spatialability, and psychomotor speed is used to describe any impairment of intellectual abilities. They include inadequacy in social or occupational activities. Mild cognitive impairment (MCI) that estimates from 3% to 42% in adults aged 65 years or older is different from dementia. In MCI cases the cognitive impairment is not severe enough to interfere with instrumental activities of daily life. MCI is important because it constitutes a high-risk group for dementia. Dementia is decline of cognition that is significant enough to interfere with independent daily functioning. But it should be noted that some diseases can lead to dementia-like conditions. Therefore, since the prime purpose of the case evaluation is to conclude the treatable causes, detailed anamnesis, family interview, comprehensive physical examination, and appropriate blood tests as well as additional cognitive screening tests should be performed. There are several cognitive screening tools to be used in the primary care setting, and the appropriate one should be selected according to the patient’s literacy and educational level. Finally, it is crucial that a patient with cognitive complaints should be referred to the reference memory center for differential diagnosis, after initial appropriate clinical and biochemical evaluations and screening for cognitive impairment in the elderly.

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Authors and Affiliations

  1. Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

    Neziha Ulusoylar, Fatma Sena Dost & Ahmet Turan Isik

  2. Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Pinar Soysal

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  1. Neziha Ulusoylar
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  2. Fatma Sena Dost
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  3. Pinar Soysal
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  4. Ahmet Turan Isik
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Correspondence to Ahmet Turan Isik .

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Editors and Affiliations

  1. Primary Care Department USL Toscana Sud Est, Grosseto, Italy

    Jacopo Demurtas

  2. Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy

    Nicola Veronese

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Ulusoylar, N., Dost, F.S., Soysal, P., Isik, A.T. (2022). Approach the Older Patients with Cognitive Impairment in Primary Care. In: Demurtas, J., Veronese, N. (eds) The Role of Family Physicians in Older People Care. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-030-78923-7_11

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  • DOI: https://doi.org/10.1007/978-3-030-78923-7_11

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