A brief look at diagnosing neurocognitive disorders in a VA primary care setting: Understanding the practices of our physician partners and the future of integration

Abstract

Objective

The population aged 65 and over is growing rapidly and with it are increased demands for integrative care and management of cognitive health issues. Such care models often do not include neuropsychologists or other psychology specialties.

Methods

In this study, 72 medical charts of VA patients diagnosed with neurocognitive disorders were reviewed using best practice guidelines for diagnosing and managing neurocognitive disorders, adapted from Downs et al. (2006).

Results

Results indicated that physicians typically used clinical judgment through review of medications, blood work within the past year, and a history of symptoms to make diagnostic conclusions. Cognitive assessment and consideration of other reversible causes of cognitive decline (e.g., depression) were less commonly considered.

Conclusions

The results are discussed in terms of potential implications for neuropsychologists and the integration of neuropsychology and primary care.

Keywords:

• Neuropsychology
• primary care
• neurocognitive disorders
• cognitive testing
• dementia

Acknowledgments

The authors would like to thank Allison Karst, PharmD, BCPS for her assistance with reviewing medication records for this project.

The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the VA, US Government, or the authors’ other university affiliations.

Disclosure statement

The authors have no conflict of interests in which to disclose.

Additional information

Funding

This project was supported by the VA Tennessee Valley Healthcare System and did not receive outside funding.