Cognitive Impairment Detection and Earlier Diagnosis

KAER Toolkit: 4-Step Process to Detecting Cognitive Impairment and Earlier Diagnosis of Dementia

Approaches and tools for primary care providers

This comprehensive toolkit is focused on the KAER model developed by the GSA Workgroup on Cognitive Impairment Detection and Earlier Diagnosis. The workgroup identified valuable tools and resources to implement the four steps in the KAER model. The resulting toolkit provides options for each of the steps so that PCPs, health plans and health care systems can select the approaches and tools that fit best with their existing primary care structure, organization, and procedures.

The toolkit is broken down by each section of the KAER model to allow quick and easy access:

• Kickstart the cognition conversation
• Assess for cognitive impairment
• Evaluate for dementia
• Refer for community resources

Each step in the model will help the PCP initiate conversations about brain health, detect and assess cognitive impairment, diagnose dementia, and provide post‐diagnostic referrals for education and supportive community services for persons with dementia and their family caregivers.

There also is a free companion webinar, "How to Use the GSA KAER Toolkit: A 4-step Process to Detecting Cognitive Impairment and Earlier Diagnosis of Dementia."

KAER Toolkit Table of Contents

List of Approaches and Tools Found in the Toolkit

• Two-page summary document of the toolkit's contents

Introduction

• The KAER Model (Page 6)
• Objectives and components of the toolkit (page 8)
• General tips for communications with older adults (page 10)
• Terms and definitions (page 10)
• Appendices — Tools to Use (page 11)

Step 1: Kickstart the Cognition Conversation

Having Healthy Conversations with patient and caregivers

Discuss with patients and caregivers brain health, their observation of signs and symptoms and cognitive impairment and other cognition concerns.

• Overview (page 15)
• Approaches (page 18)
• Appendices — Tools to Use (page 27)

Step 2: Assess for Cognitive Impairment

Tests and structured assessments tools to detect cognitive impairment.

Tests and structured assessments to determine which older adults should receive or be referred for a diagnostic evaluation.

• Overview (page 52)
• Approaches (page 54)
• Appendices — Tools to Use (page 68)

Step 3: Evaluate for Dementia

If cognitive impairment is detected conduct or refer for a diagnostic evaluation.

Tools and recommendations to evaluate the patient’s cognitive impairment.

• Overview (page 88)
• Approaches (page 94)
• Appendices — Tools to Use (page 109)

Step 4: Refer for Community Resources

Community and other resources for caregivers and adults with dementia.

Community resources to help the patient and caregivers identify needs and assess help.

• Overview (page 137)
• Approaches (page 139)
• Appendices — Tools to Use (page 142)

KAER Toolkit Updates

Use the sign up form below to receive notifications when updates are made to the KAER toolkit.

Additional Resources

• The Gerontological Society of America Workgroup on Cognitive Impairment and Earlier Diagnosis: Report and Recommendations
  • The cognitive assessment tools mentioned in this report are accessible from the following two websites: the Alzheimer’s Association and the National Institute on Aging
• December 2017 webinar: "How to Use the GSA KAER Toolkit: A 4-step Process to Detecting Cognitive Impairment and Earlier Diagnosis of Dementia"
  • Webinar slides
• January 2015 webinar: Medicare Annual Wellness Visit as Springboard to Detection of Cognitive Impairment, Diagnosis, and Post-Diagnosis Support
  • Webinar slides
• November 2014 symposium: Medicare Annual Wellness Visit as Springboard to Detection of Cognitive Impairment, Diagnosis, and Post-Diagnosis Support handouts

Workgroup Members

This program is developed by GSA and supported by Eli Lilly and Company.