Dementia Risk Reduction in Geriatric Primary Care: A Needs Assessment

Background: Dementia is a costly disease that profoundly impacts patients, caregivers, and health systems, and increasing disease-related morbidity threatens to overwhelm an already overburdened healthcare infrastructure. Although there is no cure for dementia, it may be possible to delay the onset or even prevent some types of dementia by altering individual risk factors. Local Problem: Unfortunately, although the evidence is significant, both patients and providers lack sufficient understanding and awareness of dementia risk-reduction strategies. Methods: This project sought to establish the need for a dementia-risk-reduction program in the geriatric primary care setting and to propose a program for dementia risk factor screening and intervention. Interventions: Questionnaires assessed patients' and providers' attitudes toward dementia risk reduction, and patients received a single-sheet brain health educational flyer developed for the project. A review of The Tulane Healthy Brain Aging Initiative suggested a workflow and implementation recommendation for potential use in the Madsen Geriatrics clinic. Findings from the questionnaires and program review informed the creation of an executive summary presented for review by key strategic partners within the Madsen clinic's administration. Results: Clinical providers overwhelmingly supported adding a dementia-risk-reduction program to their active health initiatives. Most patients (68%) agreed they worry about developing dementia, but many were less confident in reducing their risk. Most (86%) expressed interest in a brain health and dementia risk reduction program. Clinic administrators were enthusiastic about considering the program but raised valid concerns about reimbursement rates for services that could impact sustainability. Conclusions: Project findings clearly establish the need for a dementia-risk-reduction program at the Madsen Geriatrics clinic. More inquiries regarding outside funding and reimbursement are needed to demonstrate the potential profitability and sustainability of the program.