Dementia is a major public health problem with a profound impact on millions of patients and their families. After age 65 the prevalence of dementia rises exponentially and doubles every 10 years. It is estimated that between 35 percent and 45 percent of persons over age 85 have a dementing disorder. The disease can span from 2 to 20 years and is a major predictor of institutionalization. The majority of patients are cared for in the community by family members at great physical, psychological, and financial cost and burden. A large proportion seek help in primary care settings.
Thoughtful, on-going support from a primary care physician can help family members and reduce some of the burden. The symptoms and behaviors of dementia can be elusive and difficult to diagnose. Consequently, the AMA developed the Practical Guide for the Primary Care Physician on the Diagnosis, Management and Treatment of Dementia, a practical tool to aid primary care physicians in the initial diagnosis of the disorder, management and treatment from diagnosis to end of life, and supportive interventions for family caregivers. To this end, we suggest ways to prevent distressing symptoms and behaviors so as to maximize independent functioning of the patient, minimize stress and burden for the caregiver, and avoid premature institutionalization of the patient.
Co-morbidity and dementia
Poor control of conditions such as congestive heart failure, coronary artery disease, or chronic obstructive pulmonary disease may adversely affect the cognitive function of patients with dementia.
Automobile driving and wandering become major safety issues for patients with dementia.