Digital cognitive assessments may offer a feasible way to screen older adults for dementia

Background and goal: Many adults aged 65 and older never receive a cognitive check during regular primary care visits. This study assessed the feasibility and acceptability of the implementation of a digital cognitive assessment for Alzheimer’s disease and related dementies (ADRD) screening in primary care.

Study approach: from June 2022 to May 2023, Seven Indiana University Health Clinics offered the five-minute digital clock and recall test on an iPad to every patient aged 65 and older. Each site set its own rules about which visiting types and which staff members would perform the screen and upload results to the electronic record for the doctor to assess. In month three, researchers introduced a registered nurse role to support patients for completing care paths if they were marked for cognitive disorders. Doctors retained discretion about follow-up.

Drug results

• Of the 16,708 patients who are eligible for screening were identified, a total of 1,808 digital cognitive assessments (10.8%) were completed by 1,722 unique patients.

• More than half (55.3%) of the eligible visits never offered the digital cognitive assessment because PCPs fell or the meeting was considered out of reach.

• Screening results: under 1,808 tests, 44.3% was categorized as unaffected, 36.5% as a borderline and 13.7% as a limitation.

• During the follow-up within 90 days before the reduced group, 2.1% received a new diagnosis of Alzheimer’s or related dementia. In addition, 5.1% received a new mild cognitive disorder diagnosis, 16.9% had arranged brain image formation and 62.7% were referred to the brain health navigator.

Why it matters: digital cognitive reviews can offer a feasible way to screen older adults during routine visits, helping those who can benefit from early diagnosis, treatment and care planning.