Public Health

Area of Science:

• Geriatrics and Gerontology
• Neurology
• Primary Care Medicine
• Cognitive Neurology

Background:

• The Wisconsin Alzheimer's Institute Dementia Diagnostic Clinic Network (DDCN) comprises interdisciplinary memory clinics in primary and specialty care settings.
• Most patients are referred by primary care physicians (PCPs), necessitating an understanding of primary care diagnostic needs for Alzheimer's Disease and Related Dementias (ADRD).

Purpose of the Study:

• To compare medical screenings and suspected etiologies between primary care-based and specialty care-based memory clinics within the DDCN.
• To identify support needs for primary care teams managing patients referred for ADRD evaluation.

Main Methods:

• Cross-sectional analysis of de-identified patient data from DDCN clinics (2021-2024).
• Data included sociodemographics, screenings, and suspected diagnoses for patients referred by PCPs.
• Chi-square tests and multivariate logistic regression were used to compare diagnostic experiences by practice setting.

Main Results:

• 17 primary care (2,605 patients) and 11 specialty care (1,309 patients) clinics submitted data.
• Significant differences (p=0.001) observed in patient demographics, visit reasons, and suspected syndromes between settings.
• Primary care clinics more frequently identified patients with no cognitive impairment (17.2% vs 12.2%), sleep issues (30.5% vs 20.5%), and ADRD with depression or sleep disorders.

Conclusions:

• Primary care-based DDCN clinics encounter a higher proportion of patients with potentially reversible causes of cognitive decline.
• Improving diagnostic and management capabilities for reversible cognitive impairment in primary care may reduce specialist referrals and wait times.
• Findings highlight opportunities to enhance primary care diagnostic practices for ADRD and related conditions.