In a Canadian context of increasing obesity and continuing cultural pressure to be thin—which affects predominantly women but increasingly men as well—dieting and disordered eating are common. However, formal eating disorders are relatively rare.
We thank Dr. Bill Dalziel, Dr. Marie-France Rivard and the P.I.E.C.E.S. consultation team for allowing us to use tools and resources that they have developed to educate primary care practitioners.
For primary care practitioners
Canadian Consensus Guidelines on the Diagnosis and Treatment of Dementia (cccdtd.ca). Guidelines for treating dementia, mild cognitive impairment and other issues related to aging and cognition.
Driving and Dementia Toolkit for Health Professionals (rgpeo.com/en/ health-care-practitioners/resources/driving.aspx). Search the title to access this guide for evaluating driving in dementia and to find screeners and strate- gies for discussing driving safety with patients and families.
Determining Medical Fitness to Operate Motor Vehicles (joulecma.ca/ evidence/CMA-drivers-guide). Guidelines developed by the Canadian Medical Association for evaluating driving in people with dementia.
Montreal Cognitive Assessment (mocatest.org). A quick cognitive screener.
P.I.E.C.E.S. (piecescanada.com). Provides aids for assessment and psychotropic use.
For patients, families and caregivers
Alzheimer Society of Canada (alzheimer.ca). Links to local support groups, online videos and information for families and caregivers.
Canadian Coalition for Seniors Mental Health (ccsmh.ca). Tools and guidelines for managing psychiatric problems in long-term care (focused on dementia), delirium, depression and suicide.
Symptom Guide Dementia (dementiaguide.com). App for caregivers of people with Alzheimer disease and dementia.
Alzheimer Society of Canada. (2010). Rising Tide: The Impact of Dementia on Canadian Society. Toronto, ON: Author.
Alzheimer Society of Canada. (2012). A New Way of Looking at the Impact of Dementia in Canada. Toronto, ON: Author.
American Psychiatric Association. (2013). Diagnosis and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: Author.
Borson, S., Scanlan, J., Brush, M., Vitaliano, P. & Dokmak, A. (2000). The Mini-Cog: A cognitive “vital signs” measure for dementia screening in multi-lingual elderly. International Journal of Geriatric Psychiatry, 15, 1021–1027.
Canadian Study of Health and Aging Working Group. (1994). Canadian study of health and aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150, 899–913.
Feldman, H.H., Jacova, C., Robillard, A., Garcia, A., Chow, T., Borrie, M. Chertkow, H. (2008). Diagnosis and treatment of dementia: 2. Diagnosis. Canadian Medical Association Journal, 178, 825–836.
Folstein, M.F., Folstein, S.E. & McHugh, P.R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.
Gauthier, S., Patterson, C., Chertkow, H., Gordon, M., Herrmann, N., Rockwood, K. Soucy, J.-P. (2012). Recommendations of the 4th Canadian Consensus Conference on the Diagnosis and Treatment of Dementia. Canadian Geriatrics Journal, 15, PMC3516356.
Holsinger, T., Deveau, J., Boustani, M. & Williams, J.W. (2007). Does this patient have dementia? JAMA: Journal of the American Medical Association, 297, 2391–2404.
Mace, N.L. & Rabins, P.V. (2001). The 36-Hour Day: A Family Guide to Caring for Persons with Alzheimer Disease, Related Dementing Illnesses, and Memory Loss in Later Life. New York, NY: Warner Books.
Nasreddine, Z.S., Phillips, N.A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I. Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society. 53, 695–699.
Patterson, C., Feightner, J.W., Garcia, A., Hsiung, G.Y.R., MacKnight, C. & Sadovnick, A.D. (2008). Diagnosis and treatment of dementia: 1. Risk assessment and primary prevention of Alzheimer disease. Canadian Medical Association Journal, 178, 548–556.
Patterson, C.J., Gauthier, S., Bergman, H., Cohen, C.A., Feightner, J.W., Feldman, H. & Hogan, D.B. (1999). Canadian Consensus Conference on Dementia: A physician’s guide to using the recommendations. Canadian Medical Association Journal, 160, 1738–1742.
Petersen, R.C., Doody, R., Kurz, A., Mohs, R.C., Morris, J.C., Rabins, P.V. . . .Winblad, B. (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58, 1985–1992.
Porsteinsson, A.P., Drye, L.T., Pollock, B.G., Devanand, D.P., Frangakis, C., Ismail, Z. & CitAD Research Group. (2014). Effect of citalopram on agitation in Alzheimer disease: The CitAD randomized clinical trial. JAMA: Journal of the American Medical Association, 311, 682–691.
Sink, K.M., Holder, K.R. & Yaffe, K. (2005). Pharmacological treatment of neuropsychiatric symptoms of dementia: A review of the evidence. JAMA: Journal of the American Medical Association, 293, 596–608.
About the authors
Kenneth Le Clair, MD, FRCPC, Professor and chair, Division of Geriatric Psychiatry and Community and Primary Care Psychiatry, Queen’s University; clinical director, Regional Geriatric Psychiatry Program, Providence Care, Kingston, ON
Dallas Seitz, MD, FRCPC, Associate professor, Department of Psychiatry, and chair, Division of Geriatric Psychiatry, Queen’s University, Kingston, ON
Julia Kirkham, MD, MSc, FRCPC, Assistant professor, Geriatric Psychiatry, Queen’s University; Providence, Care Hospital, Kingston, ON
- The Primary Care Practitioner Role
- Screening & Assessment
- Resources & References