Cognitive impairment guideline
The Guidelines and Protocols Advisory Committee’s Cognitive Impairment: Recognition, Diagnosis and Management in Primary Care guideline is available to physicians across British Columbia at www.bcguidelines.ca/guideline_cognitive.html.
The guideline provides recommendations for adults who are 19 years or older within the primary care setting and focuses on Alzheimer disease, the most common form of dementia seen in primary care. The guideline encourages early recognition and assessment of dementia and supports the development of a care plan that includes identification of community resources for patients and caregivers.
Key recommendations
• Do not screen asymptomatic population for cognitive impairment.
• Dementia can be masked in a typically structured office visit; third-party observations can be important.
• Imaging is of limited value.
• Always involve the caregiver and plan on several visits to establish and inform patient/caregiver of diagnosis.
• Introduce advance care planning early.
• Polypharmacy and multimorbidity can both be causes and effects of cognitive impairment.
• Drug treatment has limited value; first consider nonpharmacological management of the behavioral and psychological symptoms of dementia.
• Make early and regular use of adjunct services.
For the complete listing of GPAC guidelines please visit www.bcguidelines.ca.