Approach to the Older Adult With New Cognitive Symptoms

Abstract

Dementia affects nearly 50 million people worldwide, translating into one new case every 3 seconds. Dementia syndrome is one of the leading causes of disability among older adults, yet it remains vastly underdiagnosed. A timely diagnosis of dementia is essential to ensuring optimal care and support of individuals and their loved ones. Although there is no single test for dementia, health care providers can use a structured approach to the workup and management of new cognitive symptoms. Comprehensive MEDLINE and PubMed searches were performed to develop an unbiased, practical diagnostic approach to these symptoms. This review guides primary care providers in the workup, diagnosis, delivery, and initial management of patients presenting with new cognitive symptoms.

Introduction to Thematic Reviews on Aging and Geriatric Medicine

“…Readers are also referred to previous articles in Mayo Clinic Proceedings that have addressed related subjects, including exceptional human longevity 13 assessment of the older driver, 14 and assessment of older patients with cardiovascular disease. 15 In the inaugural article of this thematic review series, Tung et al 16 address the assessment and management of the older patient with new cognitive symptoms. This article covers diagnostic criteria and definitions; subtypes; risk factors; screening vs a timely diagnosis; the diagnostic process that incorporates clinical assessment, cognitive testing, and laboratory and imaging studies; delivering the diagnosis; partnership and prognosis; and the initiation of pharmacological therapy.…”