The DETECT Initiative in Early Alzheimer’s Disease:
Optimizing Collaboration and Multidisciplinary Care to Facilitate Timely Diagnosis

Podcast #4 - Primary Care Physicians
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John is a 74-year-old white man who presents to his primary care physician at the urging of his wife who is worried about him. He has lost interest in things he enjoyed, including his twice weekly pickleball game and monthly poker game. He has gotten lost twice driving; forgotten important appointments; and, at a family dinner recently, didn’t seem to recognize his daughter-in-law. He has also physically slowed down recently. He has hypertension controlled with medication; COPD managed with salbutamol; and received treatment for prostate cancer 5 years ago. All of the following should be part of your differential diagnosis EXCEPT:

Depression

Cognitive impairment

Prostate cancer recurrence

Parkinson’s disease

Neurocognitive testing and an MRI suggest John has mild dementia. What do you do next?

Refer to a dementia specialist

Begin John on symptomatic medication such as a cholinesterase inhibitor

Recommend John return to pickleball and other activities to maintain physical and mental health

All of the above