Currently, clinicians provide many services that are considered routine healthcare—vital sign measurements, blood work, and preventative screenings are all part of regular checkups.
Brain health doesn’t receive this same type of treatment, and the tools to establish a cognitive function baseline are not commonplace. Physicians often only take action when a patient has suffered a traumatic event or is experiencing obvious cognitive impairment. However, when we look at today’s evolving patient populations, there’s no question that standard healthcare practices should include brain health:
- Brain health concerns increase with age, and between 2015 and 2050, the proportion of the world’s population over 60 will nearly double from 12% to 22%. As a result, healthcare worldwide needs to prepare its systems to handle an aging population.
- Brain health is impacted by common diseases, including COVID-19. One post-COVID study found that a year after infection, over 60% of patients experienced cognitive problems like trouble with short-term memory and planning.
- Brain injuries are not confined to athletes, and, in fact, most concussions are a result of falls, car accidents, and other common mishaps. One study found that 6% of the population (both athletes and non-athletes) show signs of chronic traumatic encephalopathy.
- General brain and mental health needs to be assessed regularly, as you would other annual assessments like blood tests and physicals
- Long-term follow-up, for people who have experienced cognitive issues due to a past event—like with concussion recovery, chemotherapy-related “chemo brain,” or “pumphead” issues after cardiac surgery—or whose treatment is ongoing, such as when taking medication for mental health conditions
- Post-treatment status to ensure a return to a stable baseline
- Early warning signs, for those with a family history of conditions like Alzheimer’s or other cognitive impairments
There are a wide range of situations in which otherwise healthy people would want to establish a baseline and monitor cognitive function:
- You suspect you are at risk for mild cognitive impairment (MCI), Alzheimer’s, or other types of dementia
- You have experienced or are at risk for brain injuries resulting from activities such as sports and physical labor, or you have a family history of stroke
- You want to keep your brain healthy as you age, or optimize your everyday performance
- You are recovering from treatments that affect the brain, such as chemotherapy, anesthesia during surgery, or hormone therapy
- You want to ensure your cognitive capacity is sufficient or has returned to an acceptable level in areas where function is critical, such as working at dangerous job sites, making key decisions about finances, or getting back behind the wheel after an accident
In each of these cases, patients benefit from brain health assessments being part of their regular checkups—in other words, making cognitive care part of routine care.
3 Ways to Use Cognitive Assessments
1. Improve Routine Health Practices
Implementing cognitive care protocols as part of standard practice provides long-term insights that can only be seen if they’re measured in the first place. For example, patients can be monitored for:
- General brain and mental health, as you would other annual assessments like blood tests and physicals
- Long-term follow-up, for people who have experienced cognitive issues due to a past event—like with concussion recovery, chemotherapy-related “chemo brain,” or “pumphead” issues after cardiac surgery—or whose treatment is ongoing, such as when taking medication for mental health conditions
- Post-treatment status to ensure a return to a stable baseline
- Early warning signs, for those with a family history of conditions like Alzheimer’s or other cognitive impairments
It’s hard to determine if there is a problem without a baseline measurement to compare to. Establishing a reliable baseline for a patient’s cognitive function allows clinicians to easily perform all of the above and take a proactive approach to care.
"By objectively measuring cognition regularly, clinicians can use active patient monitoring to offer better proactive care."
2. Improve Mental Health Diagnosis and Treatment
It is abundantly clear that mental health conditions have significant impacts on cognitive function. Nearly every psychologist, psychiatrist, and neurologist hears patients complain of “brain fog,” but these cognitive changes are sometimes subtle, often ill-defined, and rarely measured. Increased awareness about the tools that can support the public’s mental health needs can help clinicians generate additional insights to provide the best possible diagnoses and treatments.
Furthermore, there’s been a growing need for better mental health solutions:
- Through the 2020 pandemic, the percentage of US adults experiencing anxiety or depressive disorders increased from 36.4% to 41.5%, and those reporting an unmet mental healthcare need increased from 9.2% to 11.7%.
- Between 2009 and 2015, mental health-related emergency department visits increased by 56.4% for pediatric patients and 40.8% for adults.
- The prevalence of children ever diagnosed with ADHD increased by 42% between 2003 (7.8%) and 2011 (11.0%). For US adults aged 18 to 44, the estimated lifetime prevalence of ADHD is 8.1%.
If a cognitive baseline is never established, when an event or episode does occur it’s much more difficult for the clinician to determine the extent of cognitive change. In these cases, the clinician lacks data that could support a confident diagnosis. In cases where a baseline is determined, when a patient experiences a decline, the clinician can easily detect this change and take action. When the patient’s cognitive measurements return to a previously established level, the clinician’s goals can vary: now they need to ensure the patient is remaining stable, ensure medications are not causing undesirable side effects, or look for early objective signs that the patient needs more care. In all of these cases, cognitive monitoring can improve diagnosis of mental health conditions with cognitive symptoms and can give a clinician more confidence that their patient’s mental health is stable or improving.
"Clinicians need modern tools to evaluate patients and provide top-tier mental health care."
3. Improve Early Detection of MCI
Historically, early detection of mild cognitive impairment (MCI) has been challenging. Generally, it is only once symptoms have advanced that an MRI, MoCA, or MMSE for dementia screening is done. Tracking patient status is complex, and MCI often goes undetected until it has progressed to the point of serious concern. In addition, it is rare for physicians to collect a personalized baseline for their patients, so tests can often only detect a severe deficit relative to the general population. How do you determine what’s “normal” for each patient? Start by establishing a baseline, which makes future assessments more relevant as personalized results can be compared to the patient’s previous scores.
"Establishing a reliable baseline for each patient allows clinicians to catch early warning signs and easily detect meaningful changes in cognition before it’s too late."
Cognition Assessments Are Critical Measurements for Brain Health
Regularly scheduled cognition assessments not only benefit clinicians who specialize in cognition, but also provide opportunity for other healthcare practitioners, such as primary care providers, to measure a core element of brain health in their routine care.
Creyos Health is an online brain health assessment platform that takes seconds to set up, is engaging and enjoyable for patients, and produces a scientifically validated cognition assessment report in as little as 15 minutes. The solution makes it easy to establish reliable baselines for longitudinal monitoring to improve ongoing care and provides easy-to-understand reporting.
Plus, Creyos Health is designed with your practice as a business in mind:
- Reduced administrative burden with automated follow-ups and other automation workflows.
- Easy-to-use provider portal to access patient results and create pre-saved configurations.
- Simple pricing and reimbursement that uses a flat annual fee model and is reimbursable using various CPT codes through both public and private insurance.
