Despite the increasing rates of cognitive complaints in older adults, cognitive impairment related to dementia is frequently under-diagnosed in primary care settings. Traditionally, neurologists diagnose Alzheimer’s disease or its precursor—mild cognitive impairment—after a detailed and lengthy evaluation.

The Montefiore Einstein-initiated 5-Cog assessment represents a novel, standardized, and brief and easy-to-use cognitive assessment tool designed for use in diverse settings with the goal to reduce disparities in pre-dementia and dementia diagnosis and treatment. Through an interdisciplinary collaboration between the Montefiore Einstein Department of Neurology division of cognitive and motor aging, and the Indiana University School of Medicine, our clinician scientists are validating the clinical efficacy of this assessment tool for clinical decision making within the primary care setting. 

Primary care teams will be prompted to give the assessments via an electronic medical record system. Responses will be automatically classified as “normal” or “abnormal” based on results, and care teams will be provided with a decision tree to ensure patients receive appropriate follow-up care and support.

The 5-Cog assessment battery, available in English and Spanish, includes a picture-based memory-impairment screening test, a short picture-based symbol match, and confirmation that a patient has cognitive complaints as well as problems with mobility. Preliminary observations from a randomized clinical trial that we are conducting at a primary care clinic in the Bronx, revealed that this screening battery resulted in an over eight-fold increase in new cognitive impairment diagnoses, and an over three-fold increase in improved dementia care by primary care physicians.  

If you are interested in enrolling a patient into this clinical trial, please call 718-920-2000. 

https://classic.clinicaltrials.gov/ct2/show/NCT05515224