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Study finds gaps in dementia care by primary care providers (PCPs) regarding comorbidities, emphasizing the need for official screening guidelines, improved risk assessment tools, and comprehensive care models.

The following is a summary of “Dementia and comorbidities in primary care: a scoping review,” published in the December 2023 issue of Primary Care by Bergman, et al.

Individuals diagnosed with dementia often present with multiple chronic conditions compared to those without dementia. This added complexity not only influences the clinical manifestations of dementia but also poses challenges in its management, thereby affecting the quality of life. Primary care providers (PCPs) play a crucial role in dementia care. However, the specific strategies and adaptations they employ to manage dementia in the presence of comorbidities remain ambiguous. For a study, researchers sought to systematically analyze recent literature elucidating the role of PCPs in dementia care, particularly concerning comorbid conditions, to identify gaps in knowledge and suggest future research directions.

A comprehensive literature search was conducted across databases including MEDLINE, Cochrane Library, and Scopus, covering the period from 2017 to 2022. Key terms associated with dementia, primary care, and comorbidity guided the search. Articles were initially screened based on titles and abstracts, followed by a detailed full-text evaluation. The selected articles were categorized based on their primary focus: ‘Risk Assessment and Prevention’, ‘Screening, Detection, and Diagnosis’, or ‘Management’. Further classification included the nature of the content, such as ‘Tools and Technologies’, ‘Recommendations for Clinical Practice’, or ‘Programs and Initiatives’.

From an initial pool of 1,058 records, rigorous screening processes led to the exclusion of 800 and 230 publications during title-abstract and subsequent full-text phases, respectively. Ultimately, 28 articles met the inclusion criteria. Notably, approximately half of these publications explored tools and technologies designed to gauge dementia risk by considering pre-existing health conditions. Alarmingly, only a solitary article furnished official dementia screening guidelines tailored for PCPs managing patients with underlying conditions. Around 30% of the literature emphasized the management aspect, predominantly focusing on multidisciplinary care models and strategies to curtail inappropriate medication prescriptions.

The study pioneers an examination into the nuanced role of PCPs concerning dementia care in the backdrop of comorbidities. Based on the insights derived, it becomes imperative for forthcoming research endeavors to enhance and validate risk assessment tools that integrate comorbidities, elucidate the intricate interplay between comorbidities and dementia care practices in primary settings, incorporate comorbidity considerations into quality benchmarks for dementia care within primary settings; and devise comprehensive care models that holistically address dementia and associated comorbidities, ensuring a person-centric approach.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02229-9