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Early detection of cognitive impairment can connect patients with evaluation and treatment sooner, but many screening methods are difficult to incorporate into routine primary care. A study led by Regenstrief Institute research scientist Arthur Owora, Ph.D., MPH, evaluated a scalable approach that combines electronic health record data with a brief patient questionnaire to identify patients who may benefit from further cognitive assessment.

More than 90% of people with mild cognitive impairment and approximately half of Americans living with Alzheimer's disease and related dementias are not recognized by health care systems. When cognitive impairment is identified, diagnosis may occur two to five years after symptoms begin.

Primary care offers an important opportunity for earlier identification, but clinicians face limited time, reimbursement constraints and restricted access to specialty evaluation. Existing screening methods may also be expensive, invasive or difficult to integrate into routine care.

"Primary care clinicians need practical tools that can help them recognize patients who may be experiencing cognitive decline without creating an additional burden for patients or care teams," said Owora. "By combining information already available in the health record with the patient's perspective, we may be able to better identify who should receive a more comprehensive assessment."

The researchers studied 321 adults age 65 and older who did not have a previously documented diagnosis of cognitive impairment. Participants received care through five Eskenazi Health federally qualified health centers in Indianapolis and nine University of Miami primary care practices in South Florida.

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