Neurodegenerative Dementias: Level of Care Pathway & Treatment Strategies

Research Objectives: To develop a level of care pathway that highlights where neurodegenerative dementias are similar and where they need to differentiate based on concurrent utilization of Mini Mental Status Exam (MMSE), Montreal Cognitive Assessment (MoCA), laboratories and biomarkers aimed at streamlining patient care and easing communication with caregivers and patients.

Design: Literature reviews combined with clinical experience were used to create a level of care pathway. The MoCA and MMSE scores were paired to clinically categorize each stage of dementia.

Setting: The level of care pathway was created based on clinical experience from memory care units, assisted living, independent living, and private practice settings.

Participants: Utilizing incidence and prevalence data of Alzheimer's, Lewy Body, and Fronto-Temporal Dementia patients, this pathway will be applicable to all patients with these neurodegenerative dementias.

Interventions: The proposed pathway correlates MoCA and MMSE scores to the progressive stages of dementias. Testing patients with these tools during the preclinical stage can be used to establish a baseline cognitive ability and when used repeatedly, show progression of the disease.

Main Outcome Measures: The proposed pathway correlates MoCA and MMSE scores to the progressive stages of dementias. Testing patients with these tools during the preclinical stage can be used to establish a baseline cognitive ability and when used repeatedly, show progression of the disease.

Results: The goal of this proposed pathway is to provide a streamlined process for managing patients with neurodegenerative dementia regardless of subtype. Using this pathway will ease communication between the healthcare team and the patient and their family. It will also provide a guideline for level of care dependent on the individual patient’s progression.

Conclusions: As we develop better tools, it may be more appropriate to differentiate early and place patients on separate management tracks. Despite these limitations, we believe the utilization of this pathway will minimize complications, cost, and caregiver burden while maximizing outcomes in the natural decline of neurodegenerative dementias.

Author(s) Disclosures: There are no conflicts to disclose for any of the authors.