Diagnostic Assessment & Prognosis Cognitive testing in older primary care patients: A cluster-randomized trial

Introduction: This study investigated whether neuropsychological testing in primary care (PC) offices altered physician-initiated interventions related to cognitive impairment (CI) or slowed the rate of CI progression. Methods: This24-month,cluster-randomized studyincluded11community-basedPC practicesrandomized to either treatment as usual (5 practices) or cognitive report (CR; 6 practices) arms. From 2005 to 2008, 533 patients aged 65 years and without a diagnosis of CI were recruited; 423 were retested 24 months after baseline. Results: CR physicians were significantly more likely to order cognitive-related interventions (P 5.02), document discussions about cognition (P 5.003), and order blood tests to rule out reversible CI (P 5.002). At follow-up, significantly more CR patients had a medication for cognition listed in their chart (P 5.02). There was no difference in the rate of cognitive decline between the groups. Discussion: Providing cognitive information to physicians resulted in higher rates of physicianinitiated interventions for patients with CI. 2015 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer’s Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).