Impaired Cognition

• Perform a patient-centred interview that will help to identify a patient that may be at risk for cognitive impairment, including current functional status, living environment, supports available and potential safety concerns.
• Perform a formal clinical assessment of dementia using an evidence based tool e.g. MOCA
• Propose an initial investigation for secondary causes of dementia
• Propose an initial management plan for dementia, including non-pharmacologic and pharmacologic options

Core Resources

Dementia

Freedman A, Vasa P Dementia One-Page Primer. DFCM Open. 2011. Available at: http://dfcmopen.com. Attribution CC BY-NC-ND

MoCA Test English

Nasreddine Z. Montreal Cognitive Assessment. Version 7.1. Available at: http://www.mocatest.org/

Supplemental Resources

Recommendations on Screening

Canadian Task Force on Preventive Health Care, Pottie K, Rahal R, et al. Recommendations on screening for cognitive impairment in older adults. CMAJ. 2016;188(1):37-46. doi: 10.1503/cmaj.141165 [doi].

MoCA Instructions English

Nasreddine Z. Montreal Cognitive Assessment (MoCA) Version 3: Administration and Scoring Instructions. May 2011. Adapted by Nasreddine Z, Phillips, Chertkow NH. Available at: http://www.mocatest.org/

Behavioural Treatment Options for Dementia

Alzheimer’s Association. Challenging Behaviors. 2011. Available at: https://www.alz.org/

CEP Guide for Primary Care Management of Mental Health and Addictions

Centre for Effective Practice in collaboration with Ontario College of Family Physicians and Nurse Practitioners’ Association of Ontario. Keeping your Patients Safe: A Guide to Primary Care Management of Mental Health and Addictions-related Risks and Functional Impairments. February 2017