Sample 61

Inclusion Criteria:This study has two cohorts: A Mild Cognitive Impairment (MCI)/Dementia cohort and a non-dementia cohort.MCI/Dementia cohort:Age 65 or greaterDiagnosis of MCI or dementia from International Classification of Diseases ICD-9 and ICD-10 codesAt least one other chronic conditionFive or more chronic medications (to include all prescription and over-the-counter medications, both scheduled and as needed)Have a primary care physician at the pilot clinic who has enrolled in the studyHave a routine, scheduled visit with a primary care physician during the pilot study period (not an urgent, acute or pre-op visit)Non-dementia cohort:Age 75 or olderNo MCI or dementia diagnosisAt least two chronic conditions documented5 or more chronic medications (to include all prescription and over-the-counter medications, both scheduled and as needed)Have a primary care physician at the pilot clinic who has enrolled in the studyHave a routine, scheduled visit with a primary care physician during the pilot study period (not an urgent, acute or pre-op visit).Care partners:Family or other companions age 21 years or greater who regularly help the patient with managing medicationsThe patient can identify a care partner who assists with medication management to complete the enrollment dyad.Patient or care partner must be able to hear well enough to participate in interviews on the telephone.Patient agrees to answer "Older Adult Screening Questions" as detailed on the Patient Screening Script.Patient's care partner must be willing to participate in the study with the patient and answer the FCMAHS at the baseline visit and at the 3-month visit.Primary care physicians:• All primary care physicians at the pilot site will be included.Exclusion Criteria:Patient/Care partner dyads:Individuals residing in long term care facilities or enrolled in hospice care at baseline will be excluded.The patient does not have a care partner that assists with medication management.The patient takes 4 or fewer different medications for all his/her health needsThe patient declines to identify his/her care partnerFor the MCI/Dementia cohort: Answers all memory questions correctly, thus receiving a score of "0" for the screening assessmentIf the patient has a designated Legal Authorized Representative (LAR) but the patient's LAR is unreachable or declines to have the patient involved in the study.The care partner declines to participate in the study as part of the patient/care partner dyad.Primary care physicians:• Physicians who only provide urgent care will be excluded.