A-56: Patient Outcomes From Cognitive Screening in Primary Care Settings in Geriatric Populations: A Scoping Review
Abstract
Objective: Many individuals initially report concern about their cognition to their primary care provider. However, there is a lack of standardized guidelines for how providers address cognitive screening practices and results, leading to variable outcomes for follow-ups and referrals. This scoping review aims to better understand care pathways for individuals who undergo cognitive screening in primary care and are suspected of having impairment, such as what referrals are made, whether patients undergo comprehensive neuropsychological testing/other diagnostic workups, or whether any family resources/support are provided. Method/Data Selection: The literature search was conducted on 03/22/2026 using the PubMed, PsychINFO, and MEDLINE databases. A total of 488 records were identified, after duplicates were removed 241 titles and abstracts were screened, 17 full text articles were evaluated, and 6 studies met inclusion criteria. Results/Data Synthesis: Patients were recruited from primary care settings (N = 18,116; mean of the average sample age = 74.94 ± 6.89 years) where they were administered the following screening measures: Mini-Cogs (n= 3), a digital cognitive assessment (n= 2), or Linus Health’s Core Cognitive Evaluation (CCE, n=1). Of individuals screened, referrals were made for: laboratory workups related to cognition (i.e., B12, TSH, and folate; 0.03-36%), neuroimaging (3.5-30%), neurology (1.3-16%), prescribed cognitive enhancing medications (e.g., cholinesterase inhibitor and memantine; 0.5-10%), dementia specialists/specialty clinics (4.3-7%), neuropsychology (0.4-3.9%), and gerontology (0.5-3.4%). Conclusions: Laboratory workups and neuroimaging were the most common types of referrals for individuals identified as having possible cognitive impairment on screening in primary care medical settings. Referrals to specialists such as specialty dementia clinics, gerontologists, neuropsychologists, and neurologists were surprisingly uncommon.