TOPLINE:

Primary care physicians (PCPs) in Ontario frequently used diagnostic tools to assess patients for Alzheimer’s disease and dementia, with usage increasing during follow-up. Antidepressants were prescribed to nearly 50% of patients with dementia and more than 70% of patients with Alzheimer’s disease.

METHODOLOGY:

• Researchers conducted a retrospective observational study using electronic medical record data from 2011 to 2021 from a single academic family practice in Eastern Ontario to study the management of dementia and Alzheimer’s disease by PCPs.
• They identified 417 individuals with dementia (mean age, 78.86 years; 54.9% women) and 71 patients with Alzheimer’s disease (mean age, 76.13 years; 61.9% women) using diagnostic codes, medication prescriptions, and keywords.
• Diagnostic and screening tools and scores for the severity of disease were examined using algorithms to assess cognitive, behavioral, and functional capabilities of patients.
• Dates for when the diagnostic and screening tools were used, and their outcomes were gathered using natural language processing. Medications analyzed included cholinesterase inhibitors like donepezil and galantamine, antidepressants, and antipsychotics.
• The mean follow-up duration was a little over 1 year for the dementia cohort and 2 years for the Alzheimer’s disease cohort.

TAKEAWAY:

• The Montreal Cognitive Assessment (MoCA) was the most frequently used scale in the dementia cohort (53.2%) and the Alzheimer’s disease cohort (84.5%), and the Mini-Mental State Examination was used in 33.8% and 60.6%, respectively.
• Diagnostic imaging was performed on most individuals (91.9% in the dementia cohort and 95.8% in the Alzheimer’s disease cohort).
• The frequency of scale administration increased in both the cohorts; mean rates doubled in the year after meeting eligibility criteria for Alzheimer’s disease compared with the year prior (0.29-0.67 times per patient-year for MoCA).
• Donepezil was the most frequently prescribed cholinesterase inhibitor, with 23.5% of patients with dementia and 47.9% of patients with Alzheimer’s disease receiving it. A little under three quarters of those with Alzheimer’s disease and half of those with dementia received antidepressants.

IN PRACTICE:

“Our study raises awareness about the importance of the use of validated tools for early detection of dementia and may lead to earlier coordination of care, which could alleviate PCPs’ patient load while improving therapeutic access and quality of life for people living with dementia and Alzheimer’s disease and their care partners,” the authors wrote.

SOURCE:

The study was led by Zahinoor Ismail, of the Hotchkiss Brain Institute and O’Brien Institute for Public Health at the University of Calgary in Calgary, Alberta, Canada. It was published online on August 16, 2025, in the Journal of Primary Care & Community Health.

LIMITATIONS:

The reliance on electronic medical records may have led to inconsistent reporting and missing information. Some patients with Alzheimer’s disease may have been missed because the eligibility criteria were not well recorded in the electronic medical records.

DISCLOSURES:

This study was supported by Hoffmann-La Roche Ltd. One author disclosed receiving funding from various organizations, including the Alzheimer’s Drug Development Foundation and Brain Canada; being an investigator on clinical trials; and serving on advisory boards and consultancies. Three authors reported employment with Hoffmann-La Roche, which funded this study, two of whom also reported holding stocks. Three other authors reported employment with Medlior Health Outcomes Research Ltd., and five authors reported employment with Queen’s University.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.