JAOA Vol 106 No 12 December 2006 686-687
Response
Anita Chopra, MD;
Kara S. Schmidt, PhD
New Jersey Institute for Successful Aging, University of Medicine and
Dentistry of New JerseySchool of Osteopathic Medicine Stratford
We thank Roy R. Reeves, DO, PhD, and Mark E. Ladner, MD, for their comments
regarding our July article (J Am Osteopath Assoc. 2006;106:412-414).
Our preliminary findings highlight significant associations between
neuropsychiatric symptoms and the degree of medical illness in outpatients
diagnosed as having dementia. We believe that primary care physicians play an
important role in screening for mental status and behavioral change when
patients report only physical symptoms. Conversely, physicians also need to be
aware that neuropsychiatric symptoms or an altered mental status may be the
only symptoms indicative of an underlying medical illness (eg, urinary tract
infection). We absolutely agree with Drs Reeves and Ladner that there is a
danger in attributing changes in mental status solely to a neuropsychiatric
origin, especially in patients with dementia.