Study Supports Use of Digital Cognitive Screening in Primary Care Workflow
Less than half of patients over age 60 receive regular cognitive assessments. But primary care practitioners (PCPs) at UMass Memorial Medical Center have found a way to integrate a digital cognitive assessment into routine visits by establishing a new workflow that addressed a critical gap in brain health screening.
Previously limited by time constraints, clinicians had little opportunity to assess cognitive function during standard appointments. A study published in JMIR Formative Research marks a significant advancement in making proactive brain health assessment both practical and scalable in primary care, according to researchers at UMass Chan Medical School. The study involved patients aged 65 years and older who were English- and Spanish-speaking.
The researchers noted that primary care providers have long expressed interest in assessing patients for mild cognitive impairment (MCI)—an early indicator of Alzheimer’s and other dementias—but time constraints often prevent routine testing. They also said that evidence shows that timely lifestyle interventions can help delay or prevent dementia.
Equipping PCPs with efficient, scalable tools such as Linus Health’s Core Cognitive Evaluation (CCE), which was used in the study, is essential to meeting this urgent need and addressing the Alzheimer’s crisis at the front lines of care.
The study aimed to evaluate the feasibility of integrating the CCE — a brief and easy-to-administer tablet-based digital cognitive assessment for clinical decision-making — into primary care workflows.
Patients completed the CCE before their regularly scheduled appointments, with results provided to their PCPs in advance of the visit. Of the 150 patients screened, 40 were flagged for borderline cognitive impairment, and seven tested positive. These findings prompted PCPs to place 84 orders for follow-up lab tests or referrals to neurology and neuropsychology within 20 days.
Six of the seven participating PCPs said the CCE results directly influenced their care decisions, and all PCPs expressed interest in continuing to use the tool if it were available.
“The Core Cognitive Evaluation fit seamlessly into primary care workflows, delivering timely, actionable insights that directly influenced clinical decisions and prompted follow-up care for at-risk patients,” said lead author David D. McManus, M.D., chair and professor of medicine in the Department of Medicine, in a statement. “Digital tools like the CCE not only enable earlier detection of cognitive decline but also enhance patient engagement—patients found it easy to complete, and the vast majority wanted to know their results. This innovation empowers UMass clinicians, patients, and families alike to take proactive, informed steps to protect brain health,” added McManus, who is also executive sponsor of the Program in Digital Medicine at UMass Chan Medical School.
The researchers found that patients also responded positively: 96% said the test was easy to complete, 95% reported it did not induce worry or anxiety, and 70% found the experience beneficial. Prior to testing, 95% of patients and all caregivers expressed interest in learning whether their or their loved ones’ brain health was declining. After the assessment, 88% of patients wanted to know their results.
“The findings are great news for health systems aiming to support their patients’ brain health by providing routine cognitive screenings. The study shows that PCPs can easily integrate CCE into their workflows and use the results to inform clinical decisions,” said John Showalter, M.D., chief operating officer of Linus Health, in a statement.
