RT Journal Article
SR Electronic
T1 Feasibility and Acceptability of Implementing a Digital Cognitive Assessment for Alzheimer Disease and Related Dementias in Primary Care
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 191
OP 198
DO 10.1370/afm.240293
VO 23
IS 3
A1 Fowler, Nicole R.
A1 Hammers, Dustin B.
A1 Perkins, Anthony J.
A1 Summanwar, Diana
A1 Higbie, Anna
A1 Swartzell, Kristen
A1 Brosch, Jared R.
A1 Willis, Deanna R.
YR 2025
UL http://www.annfammed.org/content/23/3/191.abstract
AB PURPOSE We assessed the feasibility and acceptability of implementing a digital cognitive assessment (DCA) for Alzheimer disease and related dementias (ADRD) screening into primary care. We also assessed the prevalence of positive screens and measured diagnostic and care outcomes after a positive DCA result.METHODS We conducted a single-arm pragmatic clinical demonstration project in 7 diverse primary care clinics to test implementation of the Linus Health Core Cognitive Evaluation and Digital Clock and Recall DCAs (Linus Health, Inc). Eligible patients were aged ≥65 years. Patients were ineligible if unable to see or hear, not English or Spanish speaking, or if they had a DCA in the past 12 months with an unimpaired or impaired result.RESULTS There were 16,708 eligible encounters during the 12-month study period (June 2022-May 2023). A total of 1,808 DCAs (10.8%) were completed by 1,722 unique patients; 3,727 (22.3%) declined, and at 9,232 encounters (55.3%) the physicians declined to have the patient complete the DCA or the encounter was deemed out of scope. Among those who completed DCAs, results for 762 (44.3%) were categorized as unimpaired, 628 (36.5%) borderline, 236 (13.7%) impaired, and 96 (5.6%) inconclusive. Among the 236 patients who were categorized as impaired, 2.1% received a new diagnosis of ADRD, and 5.1% received a new diagnosis of mild cognitive impairment within 90 days after the DCA.CONCLUSIONS One-half of all patients scored impaired or borderline for cognitive impairment. Digital cognitive assessments can be implemented in primary care, have utility for early detection, and could represent the first step in identification of patients who could benefit from ADRD disease-modifying therapeutics, care management, or other interventions to improve patient and family caregiver outcomes.