PC‐03: The process of cognitive assessment: Engaging follow uP

SATURDAY, JULY 14, 2012 ALZHEIMER’S DISEASE IN PRIMARY CARE SETTINGS PC-01 CLINICAL USE OF IMAGING IN LIGHT OF NEW DIAGNOSTIC CRITERIA OFALZHEIMER’S Charles DeCarli, University of California at Davis, Sacramento, California, United States. Background: The newly developed diagnostic guidelines such as those developed by Dubois and colleagues in 2007 and the more recent guidelines developed under the auspice of the National Institute on Aging and the Alzheimer’s Association emphasize the use of biological markers to increase the clinical certainty of diagnosis of Alzheimer’s disease as well as potentially identify individuals at substantially high risk for incident Alzheimer’s disease. While these new guidelines do not mandate the use of specific biological markers, there is increasing emphasis on the use of neuroimaging methods to improve the accuracy of the diagnosis. This presentation will discuss the current state of the art of neuroimaging methods and how they might be clinically applied to the diagnosis of cognitive impairment syndromes. In particular, I will review the utility of structural brain MRI and amyloid imaging. Methods: Literature review. Results: Will be discussed. Conclusions: Will be discussed. PC-02 COGNITIVE ASSESSMENT DURING MEDICARE ANNUALWELLNESS VISITS Malaz Boustani, Indiana University School of Medicine, Indianapolis, Indiana, United States. Background: The Patient Protection and Affordable Care Act of 2010 added a new Medicare benefit, the Annual Wellness Visit (AWV), effective January 1, 2011. One of the requirements of the AWVis the detection of any cognitive impairment. The Alzheimer’s Association convened a workgroup of experts to develop recommendations for operationalizing the cognitive assessment component of the AWV for primary care practice.Methods: TheWork group used an iterative group-based problem solving process that was supported by a Medline search conducted in October 2011 using key words of screening or detection of dementia or cognitive impairment. To narrow examination of tools more applicable to the AWV, focus was placed on review studies published since 2000 that specifically evaluated tools for use in primary care practice. Results: Five studies using different methodologies to determine suitable cognitive performance tools for detection of cognitive impairment in primary care selected the Memory Impairment Screen, and four studies selected the Mini-Cog and the General Practitioner Assessment of Cognition. The studies found these tools most suitable for use in primary care with each having the following attributes: 1) requires 5 minutes of less to administer; 2) validated in a primary care or community setting; 3) easily administered bymedical staff members who are not physicians; 4) has good to excellent psychometric properties, performing as well or better than the mini mental status examination; 5) is relatively free from educational, language and culture bias; and 6) can be used free of charge in a clinical setting. In addition, the studies identified the AD8 and the Short Informant Questionnaire on Cognitive Decline in the Elderly as informant reporting tools suitable for the detection of cognitive impairment in primary care when a reliable informant is available. Conclusions: There are reliable and practical tools to facilitate the detection of cognitive impairment during AWV. However, cognitive assessment during the AWV is only the first step in diagnosing and managing dementia. PC-03 THE PROCESS OF COGNITIVE ASSESSMENT: