From ‘a Normal Part of Aging’ to ‘an Explanation for my Symptoms’: Insights From Patient-Care Partner Dyad Interviews About the Cognitive Impairment Diagnosis Process in Primary Care

Despite increasing pressure on primary care clinicians to provide accurate and timely assessment and diagnosis of cognitive impairment (CI), many remain unprepared. To inform improvement, we conducted interviews with 20 dyads of recently diagnosed patients and their care partners (spouses or adult children) to better understand experiences with CI assessment and diagnosis in primary care. Dyads reported wide variation in how primary care responded to their initial cognitive concerns, ranging from compassionate prioritization to minimization or attribution to age and/or physical comorbidities. Dyads also reported variability in testing, time to diagnosis, and the CI diagnosis experience. Many dyads described the challenges of living with CI including stigma, loneliness, and a desire for more support from primary care clinicians. Results identify specific areas of potential improvement in the primary care of individuals with cognitive concerns that should be embedded into point-of-care clinical decision support tools for primary care.