G. Baliga, M.L. Kerwin, D. Libon
Keywords: cognitive impairment, early diagnosis, digital assessment
Summary:Neuropsychological assessment or screening for emergent dementia has traditionally been performed in specialized outpatient memory clinics, or by psychiatrists and neurologists, on patients exhibiting mild cognitive impairment (MCI) symptoms that are evident to non-specialists. These patients, primarily age 65 and older, may be seen on a regular basis by other physician groups, including family practice and internal medicine, but they are not routinely screened for neurocognitive impairment. Cogniscreen (at https://cogniscreen.com) is a provider of novel digital tests for early detection of neurocognitive disorders such as MCI. Cogniscreen’s tests use inexpensive technology, are culturally agnostic and can be easily administered by a physician or nurse. These features make these tests excellent candidates for routine use in family practice and internal medicine locations. Recognizing the need for increased screening for dementia in our aging population, Medicare recently made available new billing codes that encourage annual neurocognitive screening. This has further increased the already existing interest in developing brief, statistically-sensitive, digitally administered and scored instruments to identify emergent but subtle to mild neuropsychological impairment. Cogniscreen’s tests are based on traditional, well-known neuropsychological paradigms that can be used to identify persons at risk of dementia, with novel scores that consider both the accuracy and the latencies in patient responses. The latencies that we consider provide a measure of the neurocognitive resources necessary to generate a response. Cogniscreen’s assessment tools are geared to maximize statistical sensitivity for subtle to mild neurocognitive disorder and designed to measure what we term cognitive vital signs. Cogniscreen’s technology is being developed at the New Jersey Institute for Successful Aging (at http://njisa.rowan.edu). It is also in use in a large ongoing study at the Family Practice Group at the Rowan University School of Osteopathic Medicine (at https://som.rowan.edu).