Look for observable signs and symptoms that would suggest patients are experiencing a change in everyday activities and functions indicating that further evaluation is needed. The emphasis on change reflects the core requirement for a decline in memory and other cognitive functions to justify a diagnosis of dementia.

Additional signs and symptoms may especially be observable to members of the clinical team or office staff before, during, or after a patient’s medical appointment (National Chronic Care Consortium & Alzheimer’s Association, 2003). 

For example, those employed at the primary care practice may note that the patient:

  • Fails to appear for scheduled appointments or comes at the wrong time or on the wrong day.
  • Is a poor historian.
  • Defers to a family member to answer questions directed to the patient.
  • Repeatedly and apparently unintentionally fails to follow instructions (e.g., using medications improperly).

“Look for signs and symptoms that suggest a change in everyday activities and functions”

Health care teams that have been caring for a patient over a period of years may notice changes in the individual’s cognitive functioning and abilities that might not be noticed in a patient being seen for the first time. The whole primary care team can contribute to these observations. Indeed, some signs (e.g., the patient repeatedly fails to appear for scheduled appointments) may be more readily noticed by office staff than members of the clinical team.

A range of professionals such as dentists, optometrists, and social workers who interact regularly with older adults might be the first to detect signs of impaired cognition and can encourage follow-up care with their primary care provider. The community initiative ACT on Alzheimer’s has developed a useful toolkit to increase the capacity of dental providers to care for the growing number of older adults living with dementia and to support their caregivers. Primary care providers may wish to share these resources that will prove useful for a variety of professionals with colleagues in their community.


Kickstart | Approaches to Implement

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