Comprehensive Dementia Care

With dementia management entering a new era of disease modifying therapies and rapidly developing biomarker modalities, neurology providers will see a greater proportion of what is the largest generation in history to reach age 65. Care models need to be prepared for the increase in both patients and caregivers. Our vision for this issue was to give providers tools to address the changing face of dementia care.

Although the COVID-19 pandemic accelerated our capacity to provide necessary care remotely for patients with cognitive impairment, it also contributed negatively to the mental and cognitive health of the entire population. Drs. Benesh and Agnihotri address the known effects of COVID-19 infection on cognitive impairment, including the impact of “long covid,” unmasking of incipient neurodegeneration, and management of exacerbating comorbidities.

Next, Drs. Fischer and Seeley outline the links between syndrome and etiology, as well as the impact of co-pathology on clinical presentation of neurodegenerative disease and vascular brain injury. In the age of disease modifying therapy, biomarker data will need to be interpreted judiciously as multiple pathologies have not been studied in clinical trials.

We’ve all heard that exercise is the best medicine and that we need to eat our fruits and vegetables. Lu and colleagues review the evidence supporting lifestyle factors as the greatest modifiable risk factors for the development of dementia and document the impact of lifestyle factors in cognitively impaired individuals.

Neurologists provide the best dementia care when they utilize all available resources. Dr. Clevenger and her co-authors describe the many ways Advance Practice Providers provide comprehensive care when integrated into diagnostic evaluation and ongoing care. Next, Drs. Crooks and Geldmacher summarize models of integrated care utilizing collaboration with multiple healthcare professionals.

Because adverse behaviors are a leading cause of caregiver distress and long-term care placement of a person with dementia, they can be very demanding of a neurology provider’s time. The approaches advocated by Drs. Gottesman and Jablonski empower caregivers with a rational approach to nonpharmacologic management of dementia-related behavior.

The impact of environmental and sociocultural factors on health disparities is at the forefront of the minds of healthcare systems and research efforts. Dr. Pilonieta and colleagues provide a summary of how dementia care providers can address these factors in their individual practices.

It has been our pleasure working with the authors and editorial team on this collaboration. We appreciate their dedication and expertise. We hope you will come away with several strategies to improve how you deliver dementia care.