Cognitive care is of increasing importance to an aging US patient population. Nearly 7 million Americans are living with Alzheimer’s disease, with that number expected to grow to 13 million by 2050. Yet, there’s a significant gap in the detection of mild cognitive impairment and dementia.
One survey found that only 47% of primary care providers regularly test patients 65 years and older. And up to 96% of providers are unaware of the best cognitive assessment tools to use in their practice. Healthcare providers also cite limited time to see patients, administrative burden, and a lack of specialized training as barriers to regularly assessing patients’ cognition. All of these factors contribute to the underdiagnosis of mild cognitive impairment and dementia.
To properly address this growing need while reducing the administrative burden, providers are turning to technology—investing in tools that can help them test patients for cognitive decline earlier.
But not all solutions are created equally. To truly be effective assessment tools need to balance specificity and sensitivity. They need to encourage better completion and patient compliance by being easy to administer and un-intimidating for patients to complete. And they need to not stop at just assessment, but offer providers a way to deliver complete cognitive care with care planning tools.
With a new protocol, Creyos is paving the way for earlier detection of mild cognitive impairment and dementia so healthcare providers can expand their capabilities, intervene more effectively, and improve patients’ quality of life. Introducing the Creyos dementia screen and cognitive care plan.
Read on to learn about these new capabilities, the science behind the solution, and the practical benefits for healthcare professionals.
What is the Dementia Protocol?
The dementia protocol gives every healthcare provider an end-to-end solution for providing high-quality cognitive care.
With this toolkit, primary care physicians and neurologists get access to:
- A quick cognitive screener for initial detection of impairment
- A full cognitive testing battery to help render a more precise diagnosis
- A pre-packaged cognitive care plan to ensure patient safety and caregiver support
Together, these resources enable healthcare providers to effectively detect, test, manage, and track cognitive function :
- Screener for initial detection: Our scientifically-validated cognitive screener takes less than 5 minutes to complete and identifies mild cognitive impairment (a potential early sign of dementia) more quickly and accurately than the Mini-Cog or SLUMS.
- A testing battery for cognitive and functional assessment: If impairment is detected, patients progress to complete further assessment in Creyos. The full dementia protocol includes four tasks and functional assessment questionnaires. The testing approach aligns with DSM-5 criteria and automatically tabulates results, reducing the time it takes to gather patient information and ensuring greater accuracy.
- Comprehensive care planning: For those with dementia diagnosis, providers can create detailed and personalized care plans that include lifestyle advice, medication guidance, and caregiver instructions. Templates and automated reports available in Creyos are designed in line with best practices for reimbursement and to reduce administrative time. Providers can generate a quality care plan in half the time it typically takes, helping to ensure patient safety and reduce caregiver role strain.
- Tracking: The Creyos assessments leverage a proprietary algorithm that creates infinite problem sets resulting in excellent test-retest reliability. With patient performance compared over time and against norms, reports clearly show any changes to help providers understand at-a-glance whether cognitive health has remained stable or is declining, facilitating objective discussions among providers, patients, and caregivers.
Updates to the Dementia Protocol
In 2024, we've made some important updates to the dementia screener and cognitive assessments that enhance patient experience.
- Update to dementia protocol tasks: In the 6-task dementia assessment, Grammatical Reasoning will be replaced by Digit Span. This addresses feedback from users who reported difficulties for low-literacy populations by using a task more suitable for a diverse set of patients. Previously completed assessments with Grammatical Reasoning are still valid, but starting this week the task will be replaced by Digit Span.
- Task name change: Throughout Creyos, Monkey Ladder is being renamed to Number Ladder. This better reflects its current validation in human studies rather than its non-human primate origins. The task remains the same, only the name is changed.
The Science Behind the Cognitive Screen and Care Plan
Informed by Rigorous Scientific Research
The science behind Creyos comes from over 30 years of research and a total normative database of over 85,000 participants. The cognitive screen draws from data on over 22,000 healthy individuals and 6,000 neurological patients.
Addressing the need for physicians to have a fast yet comprehensive way to detect cognitive impairment, an in-house team of Creyos scientists identified two online cognitive tasks from the established Creyos task library that result in effective, sensitive, and specific detection of mild cognitive impairment—with an 82% accuracy rate.
Early detection of cognitive impairment and dementia is critical for improving patients’ quality of life. Yet capture rates for these conditions are low using traditional tools such as the MiniCog, MoCA, and SLUMS, which lack the sensitivity to detect early stages of the condition. The Creyos cognitive screen closes this gap by having greater sensitivity—a 32% capture rate of impairment (compared to 1% by the MMSE).
Aligned to Healthcare Standards and Best Practices
The Creyos cognitive care plan is also aligned to Alzheimer’s Association standards. While there are many potential resources available for cognitive care planning, Creyos streamlines the process for physicians. The pre-packaged care plan saves time by eliminating the need to compile multiple critical documents. Plus, the report can be dynamically updated over time and automatically uploaded to patient records, to reduce administrative time.
Overall, the dementia protocol and care plan requires no additional hardware or training, can be completed at home or in a clinic, and offers a patient-friendly experience designed to improve accessibility and completion rates.
What are the Benefits?
Creyos approach to dementia screening, testing, and care planning is designed to help physicians close the gap in dementia detection and cognitive care planning.
Below we’ll provide an overview of the benefits for primary care providers, neurologists, and other healthcare professionals.
Benefits for Primary Care Providers
Primary care providers are expected to deliver complete patient care—and that includes handling brain health. In fact, under Medicare Advantage an annual wellness visit requires cognitive assessment. However, many physicians are limited by time, lack of specialized training, or administrative burden to do this efficiently.
The benefits of Creyos for primary care providers include:
- Enhanced value of service. With no specialized training required, primary care providers can expand their capabilities with Creyos and offer additional services for patients during their appointment. Regularly test cognition, screen for mental health comorbidities, and provide care planning for patients who need it.
- Better patient experience. Continuity of care is linked to better patient health outcomes. With this in mind, Creyos was designed for better specialist referrals and coordination amongst care providers. PDF reports and easily transferable patient data improve healthcare provider collaboration, streamlines referrals, and supports better patient experiences.
- Improved capture rates. Respond effectively to patients’ memory concerns using assessments with greater sensitivity and rigorous scientific backing. These assessments equip primary care providers to confidently identify if a patient requires further testing or care planning.
- Earlier dementia detection. Earlier detection means healthcare providers can initiate appropriate treatments, provide support services, and offer preventive measures to potentially slow disease progression and alleviate symptoms.
- Better operational efficiency. The cognitive screen and testing can be administered in person during the pre-visit or annual wellness visit. A patient can also complete them at home without physician oversight. Seamless communications, automated reporting, and EHR integration are built right into the Creyos platform.
- Better patient completion rates. For patients, using Creyos feels like playing a brain game. The user-friendly, gamified experience is designed to maximize completion rates. The platform also enhances accessibility by including clear written and audio instructions, and practice sessions in multiple languages (English, Spanish, and French).
Benefits for Neurologists
As specialists in brain health, neurologists often see patients with known cognitive impairments, once the condition has already progressed to a point of impacting daily life. Other screening tools only scratch the surface, and don’t provide a depth of data that could be valuable in developing more effective care plans.
In addition, a typical workflow requires time-consuming administration. A complete neuropsychological test can take several hours to administer, compile, and interpret for a patient.
The benefits of Creyos for neurologists include:
- More specific diagnosis. Balancing sensitivity and specificity, Creyos enables physicians to detect even mild cognitive impairment for earlier detection and intervention. In-depth reports highlight specific cognitive functions that are impaired, in an easy-to-interpret manner.
- Clearly defined comorbid conditions. Behavioral questionnaires are included to offer insights into a wide range of symptoms beyond cognitive impairment (e.g., depression), providing a more complete sense of the patient’s wellbeing. These support the development of personalized care plans tailored to the unique needs of patients.
- Automated scoring. The patient’s cognitive performance is benchmarked in the context of their age group against the Creyos normative database of over 85,000 participants.
- Patients retained in their care. As we mentioned earlier, continuity of care contributes to better patient health outcomes as well as operational efficiencies. With Creyos, neurologists can manage all parts of cognitive assessment and care planning, as well as address behavioral symptoms—all in one platform—meaning they can keep patients in their care.
Ready to Close the Gap in Cognitive Care?
The Creyos dementia protocol and care plan is a result of close collaboration with healthcare providers—developed with their input. With increased importance being placed on dementia capture, and a growing population impacted by this disease, this protocol equips physicians with the tools needed to successfully detect and manage cognitive decline.
The new end-to-end screening, testing, and care planning capabilities come standard as part of every Creyos online subscription.
This post was edited by Mike Battista, Director of Science and Research at Creyos (formerly Cambridge Brain Sciences).