Cognitive Screening Today and How it will Change in the Future

Current cognitive testing methods include MRIs, PET scans, and spinal taps, all of which are expensive and invasive and are only available at hospitals rather than primary care physician offices.

Fremont, CA: Alzheimer's disease and other cognitive disorders affect more than 55 million people worldwide. Diagnosis of these conditions necessitates a cancer-like approach in which patients of all ages are screened on a regular basis for the earliest possible detection, which can mean the difference between intervention and treatment. However, the healthcare system is not designed in this manner, and many patients are diagnosed too late in the disorder's progression.

Sadly, brain health is only addressed after symptoms of decline appear, but there is a long window for early intervention that current screenings are unable to detect. Alzheimer's disease, for example, can begin to form in the brain up to 20 years before symptoms appear, but detecting it is difficult. Patients may miss out on early diagnosis that can make a difference in the treatment and intervention of disorders such as Alzheimer's and Parkinson's if cognitive screenings are not performed at every wellness visit.

Current cognitive testing methods include MRIs, PET scans, and spinal taps, all of which are expensive and invasive, and are frequently only available at hospitals rather than primary care physician offices. Alternatives to these invasive imaging methods include the Montreal Cognitive Assessment (MoCA), the Mini Mental State Exam (MMSE), the MiniCog, or a Clock Drawing Test, all of which are completed on paper. Although

they are widely used, they are not very sensitive or specific, and the MoCA and MMSE scores can vary due to administration bias and patient state of mind. Simply put, pen-and-paper tests lack the sensitivity and precision needed for the early detection of cognitive disorders when utilized as the first line of defense.

The impact of COVID-19 on brain health is refocusing attention on the approach to brain health and the diagnostic gap. Bringing screening to all ages, instead of just the elderly, is critical to early detection, which can provide patients with a more effective and impactful treatment plan. Nevertheless, this will necessitate a change in routine screening schedules at every doctor's office in order to make cognitive testing a standard point of care during all wellness checks.

Instead of archaic pen-and-paper tests or invasive and costly hospital testing, modern technology can be utilized to capture digital biomarkers to aid providers in early diagnosis. Ubiquitous technologies such as tablets and smartphones are being combined with artificial intelligence to transform brain health and cognitive disorder detection. Digital biomarkers such as voice and speech patterns, visuospatial memory, dual-tasking ability, gait and balance, and fine motor control can be captured by mobile devices. After collecting hundreds of digital biomarkers, AI and machine learning analysis give an assessment of the individual's brain health in just a few minutes.