Detecting Cognitive Decline in Underserved Communities Using 5-Cog: Joe Verghese, MBBS, MS


The director of the Montefiore Einstein Center for the Aging Brain provided insight on how the 5-Cog assessment tool is specifically tailored for people from a range of racial and ethnic background, education levels, and socioeconomic circumstances. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

"I am hoping at the end of our current trial, our results are positive, and actually leads to it being adopted more widely across the nation. I think the primary focus—no pun intended—is primary care clinics, because that is the front line where most patients come in. But there has been interest from other groups."

There are currently more than 6 million Americans older than 65 years who are living with Alzheimer disease (AD), a number that is expected to rise over the coming decades. Traditionally, neurologists diagnose AD or its precursor, mild cognitive impairment, after a lengthy evaluation; however, most of these patients are first met in primary care settings. Understanding the slight changes in a patient, especially someone who may be more genetically at-risk, can ultimately lead to earlier intervention and better long-term outcomes.

In December 2022, the National Institutes of Health granted a $11 million grant to investigators at Albert Einstein College of Medicine, Montefiore Health System, and Indiana University School of Medicine, to evaluate the use of the 5-Cog assessment. This tool involves a picture-based memory-impairment screening test, a short picture-based symbol match, and confirmation that a patient has cognitive complaints and problems with mobility. The study will enroll 6600 participants presenting with cognitive concerns in 22 primary care clinics in the Bronx and Indiana.

Given the diverse population of the Bronx, the tool was designed for people with a range of racial and ethnic backgrounds, educations levels, and socioeconomic circumstances. Recently, principal investigator of the grant Joe Verghese, MBBS, MS, sat down to discuss how it reaches these groups, as well as some of the differences in how patients cognitively decline. Verghese, director of the Montefiore Einstein Center for Aging Brain, also detailed the clinical applicability of the tool, and why primary care clinics across the country could benefit from it.

1.$11M NIH grant will support evaluation of Alzheimer’s screening tool in primary care settings. News release. Montefiore Health System. December 8, 2022. Accessed January 6, 2023.
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