Cognitive care solutions combine behavioral questionnaires with online cognitive tasks to assess cognition, guide intervention, and monitor change over time.
According to Alzheimer’s Disease International, an estimated 78 million people worldwide will be living with dementia by 2030. With this rising health crisis, implementing cognitive care solutions in primary care opens the door for early interventions that can improve health outcomes for patients with cognitive impairment.
Article Highlights
Cognitive care solutions span three functions: assessment, intervention, and ongoing monitoring.
- An estimated 78 million people worldwide will be living with dementia by 2030.
- An estimated 40% of dementia cases can be tied back to modifiable risk factors.
- Creyos offers 12 online cognitive tasks, each taking 2 to 3 minutes to complete.
Cognitive care is an essential component of whole-person care and takes into account how cognitive health impacts other domains of health. In addition to treating new symptoms as they arise, providers must take a proactive approach to cognitive care by implementing early screening for the best chance of improving a patient’s overall quality of life.
In this article, we will explore different cognitive care solutions and interventions that can be smoothly incorporated into clinical practices.
How does cognitive care fit into overall health management?
Cognitive health care is interconnected with patients’ mental, physical, behavioral, and social health. By exploring how brain health affects and is affected by other domains of wellness, healthcare providers can improve overall health management.
Cognitive health and physical health are directly linked. Research demonstrates that patients are at an increased fall risk beginning four years before dementia diagnosis, and this risk reaches its peak in the year of diagnosis. By proactively screening for symptoms of cognitive impairment, providers can potentially reduce associated health risks and improve patients’ overall health.
The relationship between physical and cognitive health goes both ways. The National Institute on Aging reports that managing cardiovascular health in early adulthood can reduce the risk of cognitive impairment later in life.
Here are three ways that cognitive care solutions can be implemented into health management strategies for patients:
Cognitive assessment
When patients or their caregivers come to providers with concerns about symptoms like forgetfulness, testing cognitive function is often the first step. Cognitive care solutions allow providers to administer quick and accessible screens to gain insight into patients’ cognitive abilities.
Behavioral questionnaires and interviews with patients and their families are useful for gathering a subjective report of symptoms. When combined with online cognitive tasks like those offered by Creyos, providers can also gather real-time, objective insights into a patient’s memory, reasoning ability, processing speed, and overall cognitive performance.
With this data at hand, providers can discuss results with patients and determine whether additional assessment or more in-depth neurocognitive testing would be beneficial.
Intervention
Once symptoms of cognitive impairment are flagged, the next step is likely to determine an appropriate treatment intervention for the patient. The most effective approach to symptom intervention may be different for individual patients depending on their personal preferences, lifestyle, and health status.
A patient-centered approach can help primary care providers to effectively tailor care and optimize intervention plans. Patient-centered care gives providers insight into patients’ interests and medical capacity. One study found that patients reported healthcare providers could deliver better care if they knew more about them as individuals.
For example, if a patient who loves to use their phone is having trouble remembering when to take their medications, a provider might suggest a medication management app rather than immediately suggesting home health care options.
Additionally, when cognitive care solutions are delivered quickly, like those conducted at home, providers can use the appointment time to get to know patients’ unique wants and needs.
Monitoring
Ongoing monitoring is a key part of delivering effective cognitive care. A single screening offers a moment-in-time view, but tracking longitudinal data can show how a patient is responding to their treatment plan. This insight is especially valuable in primary care, where a subtle decline in cognitive ability may warrant further assessment for comorbid health conditions.
Regular reassessment and check-ins allow cognitive care to become proactive, data-informed, and aligned with the patient’s overall health goals.
What other conditions are associated with cognitive decline?
Several conditions beyond Alzheimer’s disease and other dementias can manifest as cognitive decline, and they affect patients across age demographics.
Incorporating cognitive screening into primary care can help to support patients with:
- Concussions and other traumatic brain injuries (TBI): Along with experiencing cognitive impairment, one-third of children who experience concussions may develop a mental health condition like anxiety or depression. Age-appropriate cognitive and behavioral health solutions support patients of all ages managing the aftermath of brain injuries.
- Neurological conditions: In the early stages of Parkinson’s disease, 40% of patients experience mild cognitive impairment (MCI), and more than 80% of patients will develop dementia in later stages of the disease. Keeping cognition in mind when working with these patients helps offer the best possible care.
- Mental health disorders: For patients with concurrent depression and cognitive disorders, cognitive impairment is present during depressive episodes up to 94% of the time, and up to 44% of the time during remission periods. Implementing cognitive care solutions that include mental and behavioral health assessments can help track comorbidities and identify the root cause of symptoms.
- Sleep disorders: Poor sleep has a measurable impact on cognition. Almost 70 million Americans have sleep disorders, and most go undetected in primary care. Considering patients’ sleep quality when analyzing their cognitive abilities adds essential context to result interpretation.
- Chronic illness and pain: Between 15% and 40% of people living with chronic illnesses like fibromyalgia report experiencing brain fog. Cognitive care solutions can identify the tangible cognitive impact of chronic pain so providers can build personalized treatment plans.
Benefits of cognitive and behavioral health solutions in primary care
Often, patients only seek medical help after exhibiting noticeable symptoms, like memory loss or confusion. Regular screening can catch the more subtle signs of early cognitive decline, allowing for timely intervention before impairment escalates.
Cognitive health solutions, like those offered by Creyos, allow for the continuous, proactive care of cognitive, behavioral, and mental health conditions. These solutions streamline clinician workflows, improving patient care while reducing administrative burden.
What are the main types of cognitive care interventions?
Currently, there is no cure for dementia, but with early screening, cognitive care interventions can better help to maintain patients’ quality of life as they manage long-term cognitive decline. For dementia patients, maintaining autonomy as long as possible is a high priority.
Cognitive care planning determines a course of treatment that can help patients maintain as much independence as possible while they adapt to changes in their cognitive function.
These are a few interventions providers can use as part of a comprehensive toolkit for proactive, personalized patient care:
Medication management
While no medication can stop or reverse the effects of dementia-related cognitive decline, there are options for symptom management:
| Medication class | What it addresses |
|---|---|
| Anti-amyloid antibody intravenous (IV) infusion therapies like Donanemab (Kisunla) and Lecanemab (Leqembi) | May be used in some cases to stabilize symptoms of MCI or mild dementia from Alzheimer’s disease in people with confirmed biomarkers of the disease. |
| Cholinesterase inhibitors | A class of medications that can be used to support communication between nerve cells, which may help treat symptoms related to memory and learning. |
| NMDA (N-methyl-D-aspartate) receptor antagonists like memantine | Used in some patients to treat more advanced symptoms of Alzheimer’s disease. |
| Blood pressure and cholesterol medications | May be used to help prevent additional brain damage for patients with vascular dementia. |
When including medication in cognitive care interventions, re-testing is important for gathering objective data regarding treatment effectiveness.
Mental and behavioral health therapies
When it comes to behavioral health solutions, there are multiple therapeutic interventions available for patients exhibiting symptoms of dementia. Some of these include:
- Cognitive stimulation therapy (CST): Activities designed to support brain fitness, such as puzzles, word games, number games, and practical leisure activities, have helped some dementia patients’ mental capacity and short-term memory in small studies. However, simple commercial brain training does not generally lead to significant improvements, especially in healthy adults.
- Psychotherapy: Psychotherapy is an intervention that may be used to assist patients with comorbid anxiety and depression. One study found that psychotherapy helped 62% of dementia patients with symptoms of anxiety and depression, conditions that impact about 38% of patients with mild dementia.
- Cognitive behavioral therapy (CBT): CBT is a specific type of psychotherapy used to help treat mental health conditions. In CBT, patients work with mental health professionals to structurally analyze the thinking patterns that contribute to life issues or mental health. Treating these conditions is beneficial for cognitive health, since depression and anxiety are found to worsen dementia symptoms.
- Reminiscence therapy (RT): Sharing life stories with the help of photographs or music can help dementia patients’ mood and communication skills, leading to improved quality of life.
- Creative art therapy: While the cognitive efficacy of art-based therapies requires more research, they may be used to improve patients’ self-esteem, help them communicate, and meet their emotional needs.
- Multimodal cognitive enhancement therapy (MCET): A cognitive enhancement therapy program of this kind combines cognitive, mental, and behavioral health treatments for seniors with mild cognitive impairment or mild dementia. Effective cognitive therapy often includes many of the above treatments.
Lifestyle changes
According to the Alzheimer's Society, an estimated 40% of dementia cases (particularly Alzheimer’s disease and vascular dementia) can be tied back to modifiable risk factors. These risk factors include:
- High blood pressure
- Smoking
- Type 2 diabetes
- Mid-life obesity
- Lack of physical activity
- Poor diet
- Excessive drinking and alcoholism
- Low cognitive engagement
- Depression
- Traumatic brain injuries (TBI)
- Hearing loss
- Social isolation
- Air pollution
A whole-person approach to cognitive care therapy targets these modifiable risk factors, thereby improving patients’ health on multiple fronts. One study used Creyos to demonstrate that a multimodal intervention combining multiple lifestyle changes delayed cognitive decline in at-risk older adults.
Other lifestyle intervention programs like Dementia Lifestyle Intervention for Getting Healthy Together (DELIGHT) encourage the social elements of exercise, healthy eating, and mental wellness. Integrating cognitive care into primary care can include providing a list of these types of resources for patients with cognitive impairment.
Regular cognitive screens
Routine cognition assessments gather objective data about how effective different cognitive health interventions are for patients. Re-testing is key for tracking long-term changes in cognition as compared to established baselines.
Should results indicate steady cognition, or even positive changes, these data can encourage patients to keep up with their treatment plans and combat feelings of hopelessness about cognitive decline.
Cognitive care solutions from Creyos
Creyos offers a modern, scientifically validated suite of cognitive care solutions that seamlessly integrate into clinical settings. With quick, remote-ready assessments and real-time results, these digital solutions make cognitive and behavioral health screening more accessible and efficient.
Creyos cognitive care solutions include a suite of standardized behavioral and mental health questionnaires, as well as a suite of 12 online cognitive tasks. These research-backed tasks measure cognitive skills, including working and episodic memory, reasoning, concentration, and more. Together, these solutions gather both objective and subjective patient data for deep insight into patients’ brain health.
Creyos’s tasks take 2 to 3 minutes each to complete and automatically adjust the difficulty level based on patient performance for more efficient testing. Longitudinal monitoring is supported through data-driven reports that outline the effects of cognitive health interventions over time.
Some key features of the Creyos cognitive care solutions include:
- Remote or in-clinic administration: Creyos supports telehealth, routine check-ins, and patients with limited mobility.
- Electronic health record (EHR) integration: EHR integrations allow clinicians to seamlessly share insights with entire care teams.
- Instant, easy-to-read reports: Simple-to-understand reports make it easy to provide patients with better-informed, collaborative care.
- Automated workflow tools: Tools like the HIPAA-compliant provider portal help manage patients, automate reminders, and schedule longitudinal tracking with ease.
- Simple pricing and reimbursement: The Creyos platform is a subscription-based solution with a flat annual fee and may be reimbursable for certain providers through CPT codes for annual wellness visits, telehealth, and more.
Creyos empowers primary care teams to identify cognitive concerns earlier, monitor patients over time, and deliver data-driven care, without overwhelming their workflow.
How whole-person care keeps the brain stronger for longer
Overall, addressing cognitive health is a critical part of proactive, whole-person care. By gathering both objective and subjective cognitive data, primary care doctors can take a personalized approach to treatment plans that support patients’ specific health goals.
Integrating cognitive care solutions into routine care improves outcomes and meets the growing demand for smarter, data-informed primary care.
Reviewed by Mike Battista, Director of Science & Research at Creyos
Mike Battista specializes in brain health, cognition, and neuropsychological testing. He received his PhD in personality and measurement psychology at Western University in 2010 and has been doing fun and useful stuff in the intersection between science and technology ever since.