Digital cognitive screening during routine visits to the general practitioner can contribute to earlier recognition and treatment of dementia. This is evident from three recent studies conducted under the leadership of researchers from the Indiana University School of Medicine. By using a simple digital test during consultations, cognitive problems can be identified more quickly, enabling patients to receive the right care sooner.
In one of the studies, published in Annals of Family Medicine, a five-minute digital cognitive assessment via an iPad app was offered to all patients aged 65 and older in seven primary care clinics in Indiana. Of the 1,808 tests performed, nearly 14 percent showed signs of cognitive impairment. These patients were then referred for additional testing, with 2 per cent receiving a new diagnosis of Alzheimer's or related dementia within 90 days. Another 5 per cent were diagnosed with mild cognitive impairment.
Brain Health Navigator programme
A large proportion of patients were also referred to IU Health's Brain Health Navigator programme. This programme offers additional screening and guidance for people with early signs of cognitive decline. According to Dr Diana Summanwar, co-author of the first study and principal investigator of the second, the results show that digital cognitive assessment is a valuable addition to standard care in general practice.
‘Digital tools make it possible to make conversations about brain health a structural part of routine care,’ says Summanwar. ‘Previously, these conversations were often avoided or postponed. Now we can identify problems more quickly and take targeted follow-up steps.’
Evaluation of screening tool
A second study evaluated the use of the digital screening tool from the perspective of healthcare providers in the participating practices. Four of the seven clinics have now fully incorporated the programme into their working methods. This study showed that successful implementation depends on proper integration into existing care processes and sufficient support from healthcare providers.
The third study, published in the Journal of Internal Medicine, focused on the clinical added value of early detection. According to lead author Dr Nicole Fowler, early recognition of cognitive disorders leads to better treatment outcomes. This can reduce the risk of falls, hospital admissions and the burden on informal carers.
Although the screenings provide valuable information, Fowler emphasises that implementation in practice requires customisation. ‘Successfully integrating digital cognitive assessments requires local adjustments that fit the culture and workflow of the clinic. The need for better diagnostics does not automatically mean that there is support for immediate implementation.’
Further research
The research team is now also investigating how technology can be further used for early detection. For example, they are looking at the use of machine learning to automatically create risk profiles and refer patients in a targeted manner. This innovation can further increase the accessibility and efficiency of cognitive screening.
The studies show that digital cognitive assessments can play an important role in improving early diagnostics in elderly care. The use of accessible technology makes it possible to recognise dementia earlier and guide patients more quickly to appropriate support and treatment.
Early diagnosis of Alzheimer's
Scientists at Mass General Brigham recently developed an innovative smell test that can be performed at home to detect early signs of Alzheimer's disease. The test measures the ability to identify and remember smells, which often declines in the early stages of cognitive impairment. In a study, older adults with cognitive impairments performed significantly worse on the test than cognitively healthy participants.
This finding highlights the potential of the smell test as a cost-effective, non-invasive method for early detection of neurodegenerative disorders such as Alzheimer's. The test, called the Aromha Brain Health Test, is designed for home use and can contribute to timely intervention and treatment.
