National Research Network

Purpose: Given the increasing age of the US population, understanding how primary care is delivered sur-rounding dementia and physicians ’ perceived barriers and needs associated with this care is essential. Methods: A 29-item questionnaire was developed by project investigators and family physician con-sultants and mailed to a random sample of 1500 US members of the American Academy of Family Physi-cians in 2008; 2 follow-up mailings were sent to nonrespondents. Physicians were queried about so-ciodemographic characteristics, practice patterns, and beliefs (including challenges, barriers, and needs) about care processes focusing on dementia among older patients. Results: The response rate was 60%, with respondents statistically comparable (P>.05) to the American Academy of Family Physicians physician population. Among physicians, 93 % screen and/or conduct diagnostic evaluations for dementia in older patients, whereas 91 % provide ongoing primary care for patients with de-mentia whether or not they screen for or diagnose dementia. Forty percent of physicians refer some patients with suspected dementia to other providers (primarily neurologists) to verify diagnosis, for comanagement, or both. Factors affecting the diagnosis of dementia and the delivery of dementia care included patient behav-ior challenges (aggressiveness, restlessness, paranoia, wandering); comorbidities (falls, delirium, adverse medication reactions, urinary incontinence); caregiver challenges (fatigue, planning for patient’s institutiona