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Implementing early detection of cognitive impairment in primary care to improve care for older adults
Nicole R. Fowler, Katherine A. Partrick, James O. Taylor, Michael Hornbecker, Kevin John Kelleher, Malaz A. Boustani, Jeffrey L. Cummings, Tim MacLeod et al.. Journal of Internal Medicine, 2025-05-23
Topic: Risk, prevention and care in population studies
Primary care is the ideal setting for early detection of mild cognitive impairment (MCI) and Alzheimer's disease and related dementias (ADRD), as it serves as the primary point of care for most older adults. With the growing aging population, reliance on specialists for detection and diagnosis is unsustainable, highlighting the need for primary care-led assessment. Recent research findings on successful brain health prevention strategies, AD diagnostic tools, and anti-amyloid treatments empower primary care to play a central role in early detection and intervention. Primary care-focused resources are being developed, including tools for cognitive assessments and materials designed to educate patients about brain health and initiate discussions on lifestyle modifications, thereby making early detection more feasible and efficient. Identifying risk factors early enables providers to implement interventions that can slow cognitive decline and improve outcomes for patients and caregivers. If left undetected and unmanaged, MCI and ADRD can lead to worse outcomes, including increased falls, hospitalizations, financial vulnerability, and caregiver stress. Early detection enables the identification of reversible causes of cognitive impairment, supports the management of comorbidities worsened by cognitive decline, mitigates safety risks, and can preserve quality of life. Importantly, primary care is essential for addressing ADRD-related health disparities that disproportionately affect racial minorities, rural populations, and those of lower socioeconomic status. With a focus on the United States healthcare system, this perspective addresses how implementing early detection practices into primary care can improve outcomes for patients and caregivers, reduce societal burdens, and promote health equity in ADRD care.
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APA 7th
Fowler, N. R., Partrick, K. A., Taylor, J. O., Hornbecker, M., Kelleher, K. J., Boustani, M. A., et al. (2025). Implementing early detection of cognitive impairment in primary care to improve care for older adults. Journal of Internal Medicine. https://doi.org/10.1111/joim.20098
Vancouver
Fowler NR, Partrick KA, Taylor JO, Hornbecker M, Kelleher KJ, Boustani MA, et al. Implementing early detection of cognitive impairment in primary care to improve care for older adults. Journal of Internal Medicine. 2025. doi:10.1111/joim.20098. PMID: 40410933.
BibTeX
@article{fowler2025-40410933,
author = {Fowler, Nicole R. and Partrick, Katherine A. and Taylor, James O. and Hornbecker, Michael and Kelleher, Kevin John and Boustani, Malaz A. and Cummings, Jeffrey L. and MacLeod, Tim and others},
title = {{Implementing early detection of cognitive impairment in primary care to improve care for older adults}},
journal = {Journal of Internal Medicine},
year = {2025},
doi = {10.1111/joim.20098},
pmid = {40410933},
url = {https://doi.org/10.1111/joim.20098}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Identifying risk factors early enables providers to implement interventions that can slow cognitive decline and improve outcomes for patients and caregivers.
- If left undetected and unmanaged, MCI and ADRD can lead to worse outcomes, including increased falls, hospitalizations, financial vulnerability, and caregiver stress.
- Early detection enables the identification of reversible causes of cognitive impairment, supports the management of comorbidities worsened by cognitive decline, mitigates safety risks, and can preserve quality of life.
- Importantly, primary care is essential for addressing ADRD-related health disparities that disproportionately affect racial minorities, rural populations, and those of lower socioeconomic status.
- With a focus on the United States healthcare system, this perspective addresses how implementing early detection practices into primary care can improve outcomes for patients and caregivers, reduce societal burdens, and promote health equity in ADRD care.
Why it matters
This article argues that primary care is the ideal setting for early detection of mild cognitive impairment and dementia, and that identifying risk factors early enables interventions that can slow cognitive decline and improve outcomes. It describes resources being developed for primary care but does not report testing of a specific detection or treatment program.
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Study details
- Evidence strengthLow
How this study scored 51/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Internal Medicine) |
| Journal's citation record | 2 / 4 | Journal of Internal Medicine: journal h-index 237 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 62 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 20.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 5 / 6 | Cited 39.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 3 / 4 | Cited 62 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Deanna R. Willis: h-index 17 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Miami: institution h-index 998 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 11 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40410933) |
| Free to read | 2 / 2 | Free to read |
| Total | 51 / 100 | — |
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Read the original
- DOI: 10.1111/joim.20098
- PubMed: 40410933
- Original source →
- Free full text: Journal of Internal Medicine →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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