"A light that is slowly going to turn off." - Dementia (Geriatric Series Part II)

In our final episode of the Geriatric series, Dr. Xu and Drs. Ouellets discuss how to manage neurocognitive disorders in elderly patients. Daniel facilitates the conversation with a sweet couple navigating these challenges.

=== Outline ===

Chapter 1: An Unexpected Diagnosis

Chapter 2: Diagnosing Dementia

Chapter 3: Dementia Treatment and Specialist Care

Chapter 4: Supporting Caregivers

=== Learning Points ===

1. Dementia is characterized by both functional and cognitive impairment. While it’s important to consider a broad differential, it’s not strictly necessary to rule out all causes of impairment before proceeding with assessment for dementia.
2. Once a diagnosis of dementia has been made, there are certain components of long-term care to be addressed. This is where referral to a geriatrician can be helpful, as they can help to connect patients with resources and help to provide long-term counseling.
3. As dementia progresses, behavioral issues in patients may emerge. It’s important to gather as much information about the context of these issues as possible, in order to think about non-pharmacologic solutions and interventions.
4. Maintain a high index of suspicion for caregiver burnout, and try to determine what resources a caregiver needs and/or if they are willing to accept help.

=== Our Expert(s) ===

Dr. Gregory Ouellet graduated from Brown University in Providence, RI with a Bachelor of Science in biology and then attended medical school at the University of Rochester. Dr. Jennifer Ouellet is a geriatrician who specializes in the care of older adults with multiple chronic illnesses. They completed their clinical training in Internal Medicine and Geriatrics at Yale and are currently full time faculty in the Section of Geriatrics.

=== References ===

1. Albrecht T, Schroeder M, LeCaire T, Endicott S, Marschall K, Felten K, Sayavedra N, Russmann S, Kern V, Blazek MC, Kales HC, Carlsson CM, Mahoney J, Walaszek A. Training dementia care professionals to help caregivers improve the management of behavioral and psychological symptoms of dementia using the DICE Approach: A pilot study. Geriatr Nurs. 2022 Nov-Dec;48:74-79. doi: 10.1016/j.gerinurse.2022.08.016. Epub 2022 Sep 22. PMID: 36155312; PMCID: PMC11881159.
2. Mehrani I, Sachdev PS. The role of Memory Clinics in the assessment and management of dementia, now and into the future. Curr Opin Psychiatry. 2022 Mar 1;35(2):118-122. doi: 10.1097/YCO.0000000000000777. PMID: 35026801.
3. Reuben DB, Romero T, Evertson LC, Jennings LA. Overwhelmed: a Dementia Caregiver Vital Sign. J Gen Intern Med. 2022 Aug;37(10):2469-2474. doi: 10.1007/s11606-021-07054-3. Epub 2021 Aug 13. PMID: 34389938; PMCID: PMC9360256.
4. van Dyck CH, Swanson CJ, Aisen P, Bateman RJ, Chen C, Gee M, Kanekiyo M, Li D, Reyderman L, Cohen S, Froelich L, Katayama S, Sabbagh M, Vellas B, Watson D, Dhadda S, Irizarry M, Kramer LD, Iwatsubo T. Lecanemab in Early Alzheimer's Disease. N Engl J Med. 2023 Jan 5;388(1):9-21. doi: 10.1056/NEJMoa2212948. Epub 2022 Nov 29. PMID: 36449413.

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.

Hosts: Helen Cai

Producers: Helen Cai, Josh Onyango, Daniel Wang

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: True Cuckoo, Asher Fulero, Dan Bodan, Ammil, Dan Bodan

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