Approaches to the Office Care of the Older Adult and the Specter of Dementia

The influx of older patients into the office-based primary care setting is a demographic reality for most practices. A shift from the disease-driven model of care delivery to one that focuses on function and quality of life should occur if primary care clinicians are to provide appropriate services to their aging patients. This article provides an introduction to the concept of incremental functional assessment and a few practical recommendations about health maintenance based on the findings of such an assessment. In addition, the emerging public health problem of Alzheimer's disease and related diseases is explored, as is the pivotal role that office-based primary care providers can play in addressing the consequences of these devastating diseases.