Article Impact Level: HIGH Data Quality: STRONG Summary of: The Annals of Family Medicine, 23(3), 191–198. https://doi.org/10.1370/afm.240293 Dr. Nicole R. Fowler et al. Journal of Internal Medicine, joim.20098. https://doi.org/10.1111/joim.20098 Dr. Nicole R. Fowler et al. The Annals of Family Medicine, 23(3), 199–206. https://doi.org/10.1370/afm.240294 Dr. Diana Summanwar et al.
Points
- Researchers from Indiana University assessed digital cognitive assessments in primary care and found that 14 percent of 1,808 elderly patients tested showed cognitive impairment requiring further evaluation.
- Of those with positive results, 2 percent were newly diagnosed with Alzheimer’s or related dementias, and 5 percent with mild cognitive impairment, showing the test’s potential for early detection.
- The second study found successful integration of these digital tests into clinical workflows at four out of seven participating clinics, emphasizing the value of local customization and structured follow-ups.
- A third study demonstrated that early detection through these assessments may reduce adverse outcomes among older adults, such as hospitalizations, falls, financial burdens, and caregiver stress.
- The studies support using digital assessments in routine care but highlight that clinician engagement and workflow integration are essential for widespread adoption and improved patient outcomes.
Summary
A series of three studies led by Indiana University School of Medicine researchers assessed the feasibility and effectiveness of implementing digital cognitive assessments (DCAs) in primary care settings for early detection of Alzheimer’s disease and related dementias (ADRD). The first study, published in the Annals of Family Medicine, involved administering a five-minute digital cognitive test to patients aged 65 or older at seven clinics. Of 1,808 tests administered, 14% of patients were identified as cognitively impaired and referred for further screening. Among these, 2% received a new ADRD diagnosis, and 5% were diagnosed with mild cognitive impairment. Approximately 63% of patients with positive results were referred to a Brain Health Navigator program for further evaluation within 90 days.
The second study, published in the Annals of Family Medicine, engaged clinicians across the seven clinics to use DCAs. It showed that four clinics fully adopted the DCA program, with clinicians integrating the assessments into routine workflows. This study emphasized the importance of local adaptations to clinic-specific needs for successful implementation. It found that structured workflows and follow-up systems are crucial for sustaining the program and ensuring its effectiveness in early dementia detection. The third study, published in the Journal of Internal Medicine, highlighted the importance of early detection in reducing the risk of adverse outcomes such as falls, hospitalizations, financial strain, and caregiver stress. It concluded that integrating digital cognitive assessments into primary care could improve early diagnosis and patient outcomes.
These studies collectively suggest that DCAs are a promising tool for detecting cognitive impairment early in primary care settings, an area where many early signs of dementia are often overlooked. While digital assessments can support early diagnosis and treatment, the success of these tools requires appropriate workflow integration and clinician support. The researchers plan to investigate the potential of machine learning algorithms further to enhance the identification of at-risk individuals and automate referral processes.
Links to the articles:
https://www.annfammed.org/content/23/3/191
https://www.annfammed.org/content/23/3/199
https://onlinelibrary.wiley.com/doi/10.1111/joim.20098
References Fowler, N. R., Hammers, D. B., Perkins, A. J., Summanwar, D., Higbie, A., Swartzell, K., Brosch, J. R., & Willis, D. R. (2025). Feasibility and acceptability of implementing a digital cognitive assessment for alzheimer disease and related dementias in primary care. The Annals of Family Medicine, 23(3), 191–198. https://doi.org/10.1370/afm.240293 Fowler, N. R., Partrick, K. A., Taylor, J., Hornbecker, M., Kelleher, K., Boustani, M., Cummings, J. L., MacLeod, T., Mielke, M. M., Brosch, J. R., Lee, J., Shobin, E., Galvin, J. E., Fillit, H., Udeh‐Momoh, C., & Willis, D. R. (2025). Implementing early detection of cognitive impairment in primary care to improve care for older adults. Journal of Internal Medicine, joim.20098. https://doi.org/10.1111/joim.20098 Summanwar, D., Fowler, N. R., Hammers, D. B., Perkins, A. J., Brosch, J. R., & Willis, D. R. (2025). Agile implementation of a digital cognitive assessment for dementia in primary care. The Annals of Family Medicine, 23(3), 199–206. https://doi.org/10.1370/afm.240294
