Dementia and comorbidities in primary care: a scoping review
Abstract Background People with dementia (PwD) are known to have more chronic conditions compared to those without dementia, which can impact the clinical presentation of dementia, complicate clinical management and reduce overall quality of life. While primary care providers (PCPs) are integral to...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Primary Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-023-02229-9 |
| _version_ | 1827581431635771392 |
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| author | Howard Bergman Soo Borson Frank Jessen Pierre Krolak-Salmon Alessandro Pirani Jill Rasmussen Jesus Rodrigo Daiana Taddeo |
| author_facet | Howard Bergman Soo Borson Frank Jessen Pierre Krolak-Salmon Alessandro Pirani Jill Rasmussen Jesus Rodrigo Daiana Taddeo |
| author_sort | Howard Bergman |
| collection | DOAJ |
| description | Abstract Background People with dementia (PwD) are known to have more chronic conditions compared to those without dementia, which can impact the clinical presentation of dementia, complicate clinical management and reduce overall quality of life. While primary care providers (PCPs) are integral to dementia care, it is currently unclear how PCPs adapt dementia care practices to account for comorbidities. This scoping review maps recent literature that describes the role for PCPs in the prevention, detection/diagnosis and management of dementia in the context of comorbidities, identifies critical knowledge gaps and proposes potential avenues for future research. Methods We searched for peer-reviewed literature published between 2017–2022 in MEDLINE, Cochrane Library, and Scopus using key terms related to dementia, primary care, and comorbidity. The literature was screened for relevance by title-abstract screening and subsequent full-text screening. The prioritized papers were categorized as either ‘Risk Assessment and Prevention’, ‘Screening, Detection, and Diagnosis’ or ‘Management’ and were further labelled as either ‘Tools and Technologies’, ‘Recommendations for Clinical Practice’ or ‘Programs and Initiatives’. Results We identified 1,058 unique records in our search and respectively excluded 800 and 230 publications during title-abstract and full-text screening. Twenty-eight articles were included in our review, where ~ 50% describe the development and testing of tools and technologies that use pre-existing conditions to assess dementia risk. Only one publication provides official dementia screening guidelines for PCPs in people with pre-existing conditions. About 30% of the articles discuss managing the care of PwD, where most were anchored around models of multidisciplinary care and mitigating potentially inappropriate prescribing. Conclusion To our knowledge, this is the first scoping review that examines the role for PCPs in the prevention, detection/diagnosis and management of dementia in the context of comorbidities. Given our findings, we recommend that future studies: 1) further validate tools for risk assessment, timely detection and diagnosis that incorporate other health conditions; 2) provide additional guidance into how comorbidities could impact dementia care (including prescribing medication) in primary care settings; 3) incorporate comorbidities into primary care quality indicators for dementia; and 4) explore how to best incorporate dementia and comorbidities into models/frameworks of holistic, person-centred care. |
| first_indexed | 2024-03-08T22:36:21Z |
| format | Article |
| id | doaj.art-56e46032ddbe475b8e54067038bd0e27 |
| institution | Directory Open Access Journal |
| issn | 2731-4553 |
| language | English |
| last_indexed | 2024-03-08T22:36:21Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj.art-56e46032ddbe475b8e54067038bd0e272023-12-17T12:25:34ZengBMCBMC Primary Care2731-45532023-12-0124111710.1186/s12875-023-02229-9Dementia and comorbidities in primary care: a scoping reviewHoward Bergman0Soo Borson1Frank Jessen2Pierre Krolak-Salmon3Alessandro Pirani4Jill Rasmussen5Jesus Rodrigo6Daiana Taddeo7Department of Family Medicine, McGill UniversityDepartment of Family Medicine, Keck School of Medicine, University of Southern CaliforniaDepartment of Psychiatry, Medical Faculty, University of CologneORPEA GroupAlzheimer’s Association “Francesco Mazzuca”Independent ResearcherSpanish Alzheimer’s Confederation (Confederación Española de Alzheimer)Italian College of General Practitioners and Primary Care (SIMG - Società Italiana Di Medicina Genrale E Cure Primarie)Abstract Background People with dementia (PwD) are known to have more chronic conditions compared to those without dementia, which can impact the clinical presentation of dementia, complicate clinical management and reduce overall quality of life. While primary care providers (PCPs) are integral to dementia care, it is currently unclear how PCPs adapt dementia care practices to account for comorbidities. This scoping review maps recent literature that describes the role for PCPs in the prevention, detection/diagnosis and management of dementia in the context of comorbidities, identifies critical knowledge gaps and proposes potential avenues for future research. Methods We searched for peer-reviewed literature published between 2017–2022 in MEDLINE, Cochrane Library, and Scopus using key terms related to dementia, primary care, and comorbidity. The literature was screened for relevance by title-abstract screening and subsequent full-text screening. The prioritized papers were categorized as either ‘Risk Assessment and Prevention’, ‘Screening, Detection, and Diagnosis’ or ‘Management’ and were further labelled as either ‘Tools and Technologies’, ‘Recommendations for Clinical Practice’ or ‘Programs and Initiatives’. Results We identified 1,058 unique records in our search and respectively excluded 800 and 230 publications during title-abstract and full-text screening. Twenty-eight articles were included in our review, where ~ 50% describe the development and testing of tools and technologies that use pre-existing conditions to assess dementia risk. Only one publication provides official dementia screening guidelines for PCPs in people with pre-existing conditions. About 30% of the articles discuss managing the care of PwD, where most were anchored around models of multidisciplinary care and mitigating potentially inappropriate prescribing. Conclusion To our knowledge, this is the first scoping review that examines the role for PCPs in the prevention, detection/diagnosis and management of dementia in the context of comorbidities. Given our findings, we recommend that future studies: 1) further validate tools for risk assessment, timely detection and diagnosis that incorporate other health conditions; 2) provide additional guidance into how comorbidities could impact dementia care (including prescribing medication) in primary care settings; 3) incorporate comorbidities into primary care quality indicators for dementia; and 4) explore how to best incorporate dementia and comorbidities into models/frameworks of holistic, person-centred care.https://doi.org/10.1186/s12875-023-02229-9DementiaAlzheimer’s diseasePrimary careComorbiditiesPerson-centred careScoping review |
| spellingShingle | Howard Bergman Soo Borson Frank Jessen Pierre Krolak-Salmon Alessandro Pirani Jill Rasmussen Jesus Rodrigo Daiana Taddeo Dementia and comorbidities in primary care: a scoping review BMC Primary Care Dementia Alzheimer’s disease Primary care Comorbidities Person-centred care Scoping review |
| title | Dementia and comorbidities in primary care: a scoping review |
| title_full | Dementia and comorbidities in primary care: a scoping review |
| title_fullStr | Dementia and comorbidities in primary care: a scoping review |
| title_full_unstemmed | Dementia and comorbidities in primary care: a scoping review |
| title_short | Dementia and comorbidities in primary care: a scoping review |
| title_sort | dementia and comorbidities in primary care a scoping review |
| topic | Dementia Alzheimer’s disease Primary care Comorbidities Person-centred care Scoping review |
| url | https://doi.org/10.1186/s12875-023-02229-9 |
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