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Recognizing cognitive impairment key to keeping older adults at home

INDIANAPOLIS Doctors, nurses and others who provide health care to older adults are often so focused on acute medical problems that they may miss symptoms of cognitive impairment. A unique educational summit to be held in April and May in Indianapolis focuses on the problem and will enhance the skills of these health-care providers in recognizing and managing cognitive impairment. The goal is to enable older adults to remain in their homes.

According to Malaz Boustani, M.D., associate professor of medicine at the Indiana University School of Medicine and a Regenstrief Institute research scientist, more than half of Americans with cognitive impairment are not recognized as having the conditions when they go to a hospital and more than three-quarters are not recognized as having cognitive impairment by their primary care physicians. The result is that less than 10 percent receive medications appropriate to their level of cognitive impairment and approximately one-quarter receive medications which are inappropriate.

"Medical professionals who care for older adults are faced with the problems of the real world providing the best care to patients with multiple acute and chronic diseases under time constraints and reimbursement pressures. We hope with this summit to provide these committed individuals with tools that will help them to identify the red flags of cognitive impairment to recognize delirium as an urgent medical syndrome, to reduce exposure to inappropriate medications, and to enable them to employ non-pharmacological methods to manage the special needs of both the patient and his family caregiver," said Dr. Boustani.

Dr. Boustani, who is a center scientist with the IU Center for Aging Research, is also the research director for the Indianapolis Discovery Network for Dementia. IDND, fostered by the research of the Regenstrief Institute, is an expanding group of researchers, clinicians, caregivers and community advocates who are working to enhance dementia care in the nation's twelfth largest city. IDND is a national model for how members of the community, caregivers, clinicians and researchers can work together to improve the delivery of dementia care.

Nearly 360 health-care providers from throughout Indiana will participate in the multi-session summit, which is funded by a $75,000 grant from Pfizer Pharmaceuticals to the Medical Education Group of Community Home Health Services. CHHS, which provides home health-care services, has partnered with IDND to sponsor the summit. In late 2007, IDND launched RAPID-PC Recognizing and Assessing the Progression of Cognitive Impairment and Dementia in Primary Care, a highly successful program.

"We hope that this summit will serve as both a local resource and a national model which will spawn similar educational opportunities to help doctors, nurses and others who take care of older adults in their homes to better deal with their often unrecognized mental health needs," said Jessie Westlund, R.N. of Community Home Health Services, part of Community Health Network.

"Recognizing and properly treating cognitive impairment will only become more important as our population ages. If we can identify and handle it appropriately, we can help keep older adults in their homes and out of long-term care facilities longer, a goal which benefits older adults and saves health-care dollars," said Dr. Boustani.


Contact: Cindy Fox Aisen
Indiana University

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