Geriatric Medicine

Cognitive Impairment 

SPECIALTY
Geriatric Medicine

CHIEF COMPLAINT
Cognitive Impairment

COMMENTS TO SPECIALIST
79-year-old Caucasian female with a past medical history of worsening memory loss. Montreal Cognitive Assessment (MOCA) exam one year-ago score of 22/30; current MOCA 18/30. Recent computerized tomography (CT) scan of the head revealed mild cerebellar and cerebral atrophy, chronic periventricular and subcortical deep white matter microvascular ischemic disease, which I suspect may indicate some underlying dementia.

MAIN QUESTION
I have reviewed with the patient and spouse the use of medications to aid in the treatment of what appeared to be underlying dementia,The medications discussed were Aricept, Exelon, as well as Donzipil. Please provide input regarding a diagnosis, as well as treatment options for possible dementia.

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Creating Connections: Physician Consultation with Specialists

An online doctor consultation with a specialist is designed to remove barriers in our healthcare system that make referrals complex and challenging for PCPs and patients. To optimize patient care, physicians are increasingly embracing tools and resources, including evolving telehealth solutions, that extend their clinical offerings without delegating patient care. Online doctor consultation, or eConsult, solutions are creating a peer-to-peer communication channel between individual PCPs and a range of specialists.

Using this technology, the providers can confer, share the patient’s medical history, and collaborate on a care plan. The patient remains in the capable hands of the PCP while benefiting from specialized medical expertise.  Online doctor consultation or using referrals play a central role in our healthcare system. Primary care providers (PCPs) deliver essential first-line health services that combat the specialist doctor shortage.

Additionally, eConsult technology has obvious benefits for patients who could not otherwise afford to see a specialist.