According to the Alzheimer's Association2021 report, more than 6 million Americans are living with Alzheimer's disease. These individuals and their families have been greatly impacted by the COVID-19 pandemic with greater caregiver burden and an increased rate of death (16% increase during the pandemic period).
Alzheimer's disease and related dementia (ADRD) are often missed in patients with diabetes. Guidelines recommend that patients with diabetes who are not diagnosed with ADRD and are 75 and older should be screened for cognitive impairment. Patients <75 should be screened when there are concerns. For more information and specific tools visit: GSA KAER Toolkit for Primary Care Teams, 2020 edition.
As per NYULH guidelines for diabetes with ADRD (linked below) a referral to neurology can be made if:
presentation of cognitive impairment is atypical
behavior issues require medication
imaging is desired
patients or families prefer.
For patients with diabetes and ADRD, re-evaluation of disease progression is recommended annually. Below are tools (linked) that can be useful in screening progression of ADRD:
Joshua Chodosh, MD, MSHS, FACP Director, Division of Geriatrics and Palliative Care
Director, Freedman Center on Aging, Technology and Cognitive Health (CATCH)
NYU CDC BOLD Public Health Center of Excellence for Early Detection of Dementia, co-Lead
NYU Alzheimer’s Disease Center ORE Core Leader
Professor of Medicine and Population Health
EQUIPED-ADRD An enhanced quality improvement initiative (QI) to improve ambulatory care for older patients with Diabetes Mellitus and Alzheimer’s Disease and Related Dementias (DM-ADRD) and their caregivers.