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This third edition, The GSA KAER Toolkit for Brain Health, has been adapted for web-based use while preserving the key approaches for implementing the KAER framework. This toolkit provides practical approaches, educational resources, and validated clinical tools to help primary care teams implement the Kickstart, Assess, Evaluate, Refer (KAER) framework as part of their efforts to support brain health and timely detection of and responses to cognitive impairment. The contents and selection of tools were developed with primary care teams as the principal audience. Others, including educators and students in disciplines such as medicine, nursing, and social work, may also find its contents useful.

Support provided by Eisai, Genentech, Lilly, and Otsuka.

In April 2024, a team of researchers from Albert Einstein College of Medicine led by Dr. Joe Verghese published the results of a randomized controlled trial examining the impact of implementing the 5-Cog Paradigm in primary care. The 5-Cog Paradigm includes a non-literacy biased, culturally fair cognitive detection tool combined with clinical decision support embedded in the electronic medical record. In this Momentum Discussion Podcast episode, Dr. Verghese discusses the unmet needs that led to the development of the 5-Cog, explains the 5-Cog Paradigm, and shares key findings from the team’s research.

This podcast episode is supported by Eisai, Genentech, Lilly, and Otsuka.

Addressing Brain Health in Adults With Intellectual Disabilities and Developmental Disabilities: A Companion to the KAER Toolkit for Primary Care Providers is designed to address the needs of adults with intellectual and developmental disabilities (I/DD) who develop dementia. This companion document complements the GSA KAER Toolkit for Primary Care Teams 

Support provided by Eisai.

Certain groups of individuals with intellectual and developmental disabilities (I/DD) develop dementia at rates similar to older adults in the general population. However, adults with certain conditions, such as Down syndrome, develop Alzheimer's disease at greater rates. During this Momentum Discussion podcast episode, our guest discusses this issue and provides an overview of unique challenges in assessing for dementia in individuals with I/DD. She discusses strategies that primary care teams and others can use from the GSA publication, Addressing Brain Health in Adults with Intellectual Disabilities and Developmental Disabilities: A Companion to the KAER Toolkit for Primary Care Providers, to improve detection of dementia and care and services for adults with I/DD.

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This podcast episode is supported by Eisai.

GSA presented this poster detailing the KAER for Brain Health Framework at the 2023 Alzheimer's Association International Conference® in Amsterdam.

Support provided by Eisai, Genentech, Lilly, and Otsuka.

Early detection of dementia leads to better outcomes for individuals with dementia and their care partners. It allows them to potentially benefit from a variety of care interventions, make decisions about their care, and tap into community resources to enhance their quality of life and function. Despite this, the Alzheimer’s Association reported that neither patients nor primary care practitioners routinely raise brain health issues – particularly in the case that a patient has signs of mild cognitive impairment. In this GSA Momentum Discussion Podcast episode, Bonnie Burman, president of the Ohio Council for Cognitive Health, discusses barriers to kickstarting brain health conversations and early diagnosis of dementia, offers strategies to overcome them, and highlights how care providers and other communities of interest can use the KAER Toolkit for Brain Health to improve early detection of dementia. 

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This podcast episode is supported by Eisai, Genentech, Lilly, and Otsuka.

A person living with dementia and their care partner often have needs for a variety of community supports that enables them to achieve their greatest potential function and quality of life. This podcast episode addresses the fourth step of the KAER Framework: Refer for Community Services. Our guests discuss how interdisciplinary care teams in primary care can use risk-based strategies to refer older adults with dementia and their care partners to appropriate community services, and they share strategies for success that they and their interdisciplinary colleagues use in the Emory Integrated Memory Care Clinic – a nurse-led primary care practice for people living with dementia. 

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This podcast episode is supported by Eisai, Genentech, Lilly, and Otsuka. 

Appropriate reimbursement for detection, evaluation, and diagnosis of dementia as well as for care planning and ongoing care of individuals with cognitive impairment and dementia is possible. In fact, pathways to appropriate reimbursement well align with evidence-based guidelines for care and expectations around quality. To ensure well-coordinated quality dementia care, the primary provider and other members of the interdisciplinary care team spend a great deal of time outside the standard primary care visit, and reimbursement for this time is available. In this podcast, our guests share their insights into the documentation, infrastructure, and processes necessary to capture appropriate reimbursement for quality dementia care. They also discuss how using reimbursement as a pathway for quality dementia care supports high-functioning teams, incentivizes care teams to provide care that aligns with guidelines, and prevents the vital work of the entire interdisciplinary team from being invisible. GSA developed this podcast and the associated Additional Handout: Podcast Discussion Points in December 2022. It is important to note that payment policies change often and vary by payor, and listeners should seek payor-specific guidance around billing for services. 

Handout: Podcast Discussion Points

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This podcast episode is supported by Eisai, Genentech, Lilly, and Otsuka.

Early detection of dementia is vital, and it allows people living with dementia to receive comprehensive care to address symptoms, build a care team, participate in supportive services, access community supports, and potentially access disease-modifying treatments or enroll in clinical trials. With early detection of cognitive impairment and disclosure of the diagnosis to the patient, the individual with the condition and their care partners can set systems in place that allow them to achieve their highest practicable level of function and quality of life. In this episode, Dr. Joshua Chodosh shares strategies to kickstart the brain health conversation, describes how he has engaged the whole healthcare team in the conversation, and highlights approaches aimed at early detection of cognitive impairment in the primary care setting. Dr. Chodosh also underscores how providers can use tools in The GSA KAER Toolkit for Primary Care Teams to enhance their early detection efforts and help to improve outcomes for older adults with cognitive impairment and their care partners. 

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This podcast episode is supported by Eisai. Content was developed by Gerontological Society of America (GSA). 

In their special report, Alzheimer’s Detection in the Primary Care Setting: Paving a Path Forward, the Alzheimer’s Association reported that despite a strong belief among older adults that brief cognitive assessments are important and that early detection of cognitive problems is beneficial, only half are being assessed for cognitive decline, and much fewer receive routine assessments. The Association’s findings about dementia care practices in primary care along with the ever-growing number of Americans living with Alzheimer’s disease and related dementias highlight the need to take a systems approach to improving dementia care. In this Momentum Discussion Podcast episode, Amy Boehm, senior health systems director for the Alzheimer's Association discusses the urgent need to improve dementia care practices in primary care, how The GSA KAER Toolkit for Primary Care Teams addresses an unmet need for primary care providers, and shares how the Alzheimer’s Association Health System Initiative can support them in implementing practice change to improve dementia care. Amy also offers strategies to get started with changing practice in any care setting. 

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For more information on speakers of this session, visit podbean for details.

This podcast episode is supported by Eisai, Genentech, Lilly, and Otsuka. 

Care teams may find it useful to reflect on their current practices using the Start, Stop, Continue, Improve Action Plan.  

A form that primary care teams can use to facilitate referrals to interdisciplinary professionals, supports, and services for individuals with dementia and their families. 

Promotes the collaboration of researchers and practitioners conducting basic or applied research on Alzheimer's Disease and the related dementias including (or as well as) Mild Cognitive Impairment (MCI). We welcome any questions and suggestions for collaborative work or collaborative symposia at GSA's annual conference.

The GSA KAER Toolkit is intended to support primary care teams in implementing a comprehensive approach to initiating conversations about brain health, detecting and diagnosing dementia, and providing individuals with community-based supports. It includes practical approaches, educational resources, and validated clinical tools that teams can integrate into their workflow. 

Click here to view a scrollable version of this publication.

For more details on how to use the KAER Toolkit, click here.

Support provided by isai, Genentech, Lilly, and Otsuka.

This is the first edition of the GSA KAER Toolkit - published in 2017. This comprehensive toolkit is focused on the KAER model developed by the GSA Workgroup on Cognitive Impairment Detection and Earlier Diagnosis. The workgroup identified valuable tools and resources to implement the four steps in the KAER model. The resulting toolkit provides options for each of the steps so that PCPs, health plans and health care systems can select the approaches and tools that fit best with their existing primary care structure, organization, and procedures. 

Support provided by Eli Lilly and Company.

With the number of older adults with Alzheimer’s disease continuing to grow (estimated at 6 million Americans in 2017), it is imperative that primary care providers conduct earlier cognitive impairment assessments to ensure that older adults receive appropriate medical care and referrals to community services that can often lead to improved health-related outcomes and well-being. The online GSA KAER toolkit provides approaches and tools for primary care providers to kickstart the cognition discussion with their patients, to assess for cognitive impairment, to evaluate and diagnose dementia, and to provide post‐diagnostic referrals for education and supportive community services for persons with dementia and their family caregivers. During this webinar, attendees will hear how the KAER model was developed, learn how to use the toolkit, and receive an overview of the approaches and featured tools to implementing each step of the KAER model. 

Support provided by an independent grant from Merck & Co., Inc.

This report addresses a serious but frequently overlooked gap in health care for the rapidly aging population of the United States: how older adults at risk for, or with signs and symptoms of, Alzheimer’s disease and related dementias are inadequately assessed for cognitive impairment during routine visits with their primary care providers. 

Support provided by Eli Lilly and Company.

The 2010 Affordable Care Act established the Medicare Annual Wellness Visit (AWV) as an opportunity for Medicare beneficiaries to receive preventive and assessment services during visits with their primary care providers (PCPs). Detection of cognitive impairment is among required AWV services, yet no specific tools are mandated and no data are available regarding tools used for this purpose. This webinar explains these and related issues being addressed by the GSA Workgroup on Cognitive Impairment Detection and Earlier Diagnosis. 

Support provided by Eli Lilly and Company.