Listen for Patient and Family Concerns About Cognition

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):

Asking the same question repeatedly.

Becoming lost in familiar places.
Not being able to follow directions.

Getting confused about time, people, and places.
Having difficulty with self-care, nutrition, bathing, or safety.
Failing to recognize scams/being victimized by scam artists.

During the Visit

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?”

Validated Questionnaire

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.

Kickstart | Approaches to Implement