Neurocognitive disorders create important challenges for patients, their families, and clinicians who provide their health care. Early/timely detection in daily clinical practice allows for diagnosis and adequate treatment, psychosocial support, education, and engagement in shared decision-making related to health care, life planning, involvement in research, and financial matters. However, neurocognitive disorders, when present, are not detected or not diagnosed and not documented, in more than half of patients seen by primary care physicians. The aim of this paper is to highlight the strategies and the perspectives to improve the early/timely detection of neurocognitive disorders in daily clinical practice.

The increasing demand for healthcare services is placing great strain on healthcare systems throughout the world. Although the older population is increasing worldwide, there is a marked deficit in the number of persons trained in geriatrics. It is now recognized that early detection and treatment of geriatric conditions (e.g., frailty, sarcopenia, falls, anorexia of aging, and cognitive decline) will delay or avert the development of disability. At the same time, recent years have seen an increased interest and use of advanced practice nurses (APN). Models of best practices of supervision and collaboration have been promulgated by many organizations. APN's roles and scope of practice have been expanded in many countries and the quality and cost-effectiveness of healthcare systems have improved. Nevertheless, in older people, evidence of advanced practice roles remains scattered, and there is little synthesis of evidence, and therefore it is not easy to visualize the different practice models and their components. The aim of this paper is to explain the need for advanced practice nurses to manage geriatric conditions.

The Rapid Geriatric Assessment (RGA) measures frailty, sarcopenia, anorexia, cognition, and advanced directives. The RGA is a screen for primary care physicians to be able to detect geriatric syndromes. Early intervention when geriatric syndromes are recognized can decrease disability, hospitalization, and mortality.

Maintaining optimal health and well-being in the older adult requires understanding of how physiologic changes influence nutritional status, familiarity with the available validated tools to assess status, identification of factors predisposing older adults to malnutrition, and evidence-based practice regarding the nutritional needs of this age group. Evidence-based guidance on these core practice components is provided to the clinician in this article.