Primary care preparedness to care for patients with ADRD: A national survey study

INTRODUCTION: It is unknown how prepared primary care practices are to deliver recommended dementia care. METHODS: A nationally representative survey of US primary care practices focused on care delivery processes, including those for patients with Alzheimer's disease and related dementias (ADRD). RESULTS: A total of 1245 of 3498 practices (36%) responded. Most practices reported systems to detect patients with ADRD (67%) and refer patients for diagnostic testing (75%). Fewer required ADRD-related training (45%-46%) or maintained an ADRD registry (29%). Practices that scored higher on ADRD care preparedness were more likely to be smaller, receive a higher proportion of revenue from Medicare, and have other important practice capabilities. DISCUSSION: Primary care practices have mixed preparedness to care for patients with ADRD. Efforts to boost ADRD preparedness, including providing adequate infrastructure and resources directly to primary care, should be a priority to address disparities in diagnosis and to optimize the patient and caregiver journey. HIGHLIGHTS: Mixed ADRD preparedness identified in primary care practices across the United States. Practices often lack ADRD-specific registries and staff training initiatives. Medicare-reliant and larger physician-owned groups show higher ADRD preparedness. FQHCs reported lower ADRD preparedness, highlighting potential gaps in care. Cultural awareness and other support services correlate with better ADRD readiness.