Overcoming Complexities With Cognitive Screening in Primary Care Centers: Nicole Fowler, PhD


The director of research for internal medicine and geriatrics at Indiana University School of Medicine provided perspective on ways to effectively streamline cognitive screening in timely and accurate manor. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

"The third piece—which is not new but interesting—there was this sense that providers were not quite sure if they believed the results. Patients who they’ve had a long-standing relationship with who they feel are doing just fine, maybe come back as yellow or red."

With the emergence of novel therapeutics, including new amyloid-targeting agents, the importance of early identification of people at risk of developing Alzheimer disease (AD) is more critical than ever. The development of feasible, acceptable, and scalable ways to identify early cognitive impairment in the primary care setting is essential, considering these are areas that will first encounter patients presenting with cognitive issues. Comprised of several institutions across the US, the DAVOS Alzheimer’s Collaborative DIGITAL Demonstration Project was conducted to understand the feasibility, acceptability, and implementation of digital cognitive screening in primary care.

Results from the initiative were presented at the 2023 Alzheimer’s Association International Conference (AAIC), held June 16-20, in Amsterdam, the Netherlands. Over a 7-month project, 3343 screening attempts were made using the Linus Health Digital Clock and Recall (DCR) cognitive assessment were made. The screening test was refused by patients more than half the time (54.6%) and was attempted but incomplete 1.9% of the time. Among these, 12% scored positive for cognitive impairment, 36% scored likely cognitively impaired, 45% scored cognitively unimpaired, and 7% had results that were unanalyzable.

Prior to the meeting, NeurologyLive® sat down with senior investigator Nicole Fowler, PhD, to discuss the findings, and how they translate to clinical practice. Fowler, director of research for internal medicine and geriatrics at Indiana University School of Medicine provided perspective on the complexities with cognitive screening in primary care settings, the need for quick and accurate tools, and the hesitancy in adapting to new digital options.

Click here for more coverage of AAIC 2023.

1. Swartzell K, Willis D, Hammers D, et al. Implementation of cognitive screening in primary care: DIGITAL-Indiana University Health System and Indiana University- A Davos Alzheimer’s Collaborative flagship site program. Presented at: AAIC 2023; June 16-20; Amsterdam, Netherlands.
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