When it comes to dementia, early detection can make a major difference for patients and their families. It opens up the possibility for earlier treatment interventions, like medication, lifestyle improvements, and the opportunity for participation in clinical trials, and connects patients with resources earlier so that they can plan for the future.
Digital cognitive testing is a fast and accessible way to integrate dementia testing into healthcare—saving time and money without sacrificing quality of care. In this post, we will review the benefits of early dementia detection and the unique ways in which online cognitive screeners can support your clinic.
Key Takeaways:
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Why Early Detection Matters for Dementia Diagnosis
By 2030, an estimated 78 million people worldwide will live with dementia—and that number is expected to jump to 139 million by 2050.
Early detection helps identify vulnerable patients before their disease progresses, improving health outcomes by:
- Delivering patient-centered care: Personalizing treatment based on a patient’s specific wants and needs prioritizes their autonomy. This patient engagement has been shown to increase the likelihood that patients will adhere to treatment plans, improve treatment outcomes, and promote open communication with providers.
- Increasing the likelihood of positive responses to pharmaceutical treatment: Patients with early Alzheimer’s disease may benefit from certain medications prescribed at the discretion of their physician. For example, lecanemab has been shown to slow early disease progression in clinical trials. However, it is not a cure for symptoms that have already appeared, so early intervention is required to realize its benefits.
- Making care plans to support families: In 2023, caregivers provided about 18.4 billion hours of care to a loved one with dementia. Early detection allows providers, patients, and caregivers to make plans to reduce caregiver burnout in the long haul.
- Reducing long-term healthcare system overload: Following the COVID-19 pandemic, geriatric care has seen an increasing rate of burnout among nurses and healthcare workers.
If every American currently living with dementia had been diagnosed when they had mild cognitive impairment, it would have saved an estimated $7 trillion in health and long-term care costs. As clinics strive to deliver value-based care, prioritizing early dementia diagnosis is essential for patients and healthcare systems’ cost-efficacy.
Early Symptoms of Potential Dementia
Early cognitive decline coupled with other symptoms of dementia is often misunderstood as a sign of normal aging. In fact, 62% of healthcare professionals believe dementia is a regular part of aging. But when symptoms are disrupting quality of life, this may be an indication that there are factors other than age-related decline at play, and that’s where cognitive testing has an important role in distinguishing symptoms of one condition from another.
According to the Alzheimer’s Association, ten symptoms associated with early dementia include:
- Memory problems that disrupt daily life: Patients may struggle with memory loss and short-term memory issues. This may include missing appointments, forgetting recent conversations, or repeating questions over the course of a conversation. This impairment is typically one of the earliest signs of mild cognitive impairment (MCI) that people may notice.
- Struggles with problem solving: For many people with early dementia, problem solving can become difficult. They may experience difficulties with planning, following multi-step instructions, or adapting to changes. This impairment can become particularly dangerous when patients are responsible for independently managing their medication.
- Struggles with familiar tasks: Many patients can find they can no longer easily complete their daily tasks. For example, they may experience new difficulty using the same TV remote they’ve had for twenty years.
- Confusion with time or place: Misjudging the date or getting lost in familiar neighborhoods is another sign of MCI or dementia as opposed to normal aging.
- Spatial troubles: Many dementia patients struggle with understanding spatial relationships. One way this appears in daily life is in driving, which can become risky when patients misjudge distance, depth, or color contrast.
- New language or speaking problems: Struggling to find words or mixing up common terms is another sign of early cognitive issues. This may be embarrassing for some seniors, and they may be reluctant to seek out any sort of dementia screening. A positive doctor-patient relationship makes patients more likely to open up.
- Frequently losing things: Misplacing items or putting them in the wrong place and not being able to retrace steps to find them can be an early sign of dementia.
- Poor judgment: Changes in judgment are a common experience for many dementia patients. This might be expressed through dressing inappropriately for the weather, trusting strangers without question, and making poor financial choices. Seniors are more susceptible to scams, and the risk of fraud increases for patients with cognitive impairment.
- Social withdrawal: Being socially isolated increases the risk of dementia by 50%, making social withdrawal both a symptom and a risk factor for dementia.
- Mood or personality changes: Changes in mood or personality can be associated with dementia.
Common Dementia Testing Tools
Some of the most common tools used to screen for dementia include:
- Montreal Cognitive Assessment (MoCA): Evaluates memory, attention, abstraction, language, and delayed recall. It has demonstrated high sensitivity to detecting severe deficits but isn’t able to pick up on subtler, early signs of MCI and dementia.
- Mini-Mental State Exam (MMSE): Tests memory, concentration, language, motor skills, spatial awareness, and problem-solving. Similar to the MoCA, it is very good at detecting advanced cognitive decline but unlikely to catch earlier stages of cognitive impairment.
- Clock Drawing Test: Patients are asked to draw a clock with a specific time. This test is quick and easy to use, but manual scoring, subjective interpretation, and low sensitivity are limitations.
- Saint Louis University Mental Status (SLUMS): This test assesses similar cognitive functions to the MMSE and MoCA but also includes extrapolation skills. It has been shown to be reasonably effective when detecting advanced dementia but may miss subtler signs, including MCI.
- Instrumental Activities of Daily Living (IADL) Questionnaire: A questionnaire used to assess a patient’s ability to perform everyday tasks. Results may indicate when further dementia testing is necessary and help build personalized treatment plans that can be informed by the patient’s level of dependence.
How Does Early Detection Impact RAF Scores?
Early detection is essential for capturing accurate RAF scores. When a dementia diagnosis is missed, health systems are unable to capture a patient’s true clinical risk and accurately estimate the cost of dementia care—even as the patient’s needs continue to rise.
Without aligned risk adjustment, practices and health systems struggle to plan resources effectively, leaving teams underfunded and potentially unable to deliver true value-based care.
What are the Benefits of Digital Cognitive Testing?
Gathering objective data
Classic dementia questionnaires can flag subjective symptoms of cognitive decline as reported by patients, but they do have limitations. Digital cognitive tests capture domain-specific insights to clearly identify any patterns of cognitive impairment that may meet the diagnostic criteria for mild and major neurocognitive disorders as opposed to normal signs of aging.
Sensitivity to the detection of mild cognitive impairment (MCI)
Traditional cognitive tests like the MoCA and SLUMS perform well when detecting signs of advanced dementia, but they have several limitations and may miss subtle symptoms of early dementia. This pushes back the timeline for a dementia diagnosis, which can have a negative impact on both the rate of care and accurate risk adjustment.
In addition, there are many causes of MCI, and flagging symptoms isn’t the same as identifying the core issue. Digital dementia screening and assessment tools can assess patterns of cognitive performance related to potentially affected brain regions, providing detailed insight as to whether or not a patient’s MCI may relate to dementia or another condition.
Longitudinal data collection
The results of pen-and-paper tests offer a snapshot of data from the day testing is delivered. However, factors like lack of sleep may impact results, making it harder to capture a complete picture during a single annual wellness visit.
Digital cognitive tests can randomize items so they cannot be memorized, making them ideal for retesting multiple times and allowing providers to gather longitudinal data that paints a picture of patient trajectories. When it comes to dementia, providers can also track the effectiveness of interventions and the progression of decline.
Remote testing opportunities
Whether it be because of physical disabilities or remote locations, many patients struggle to get to their doctor’s office. This becomes increasingly challenging when senior patients can no longer drive safely—which may be an indicator that they need extra cognitive care.
An estimated 20% of Americans live in remote rural areas. Delivering cognitive testing via telemedicine promotes accessibility and helps to prevent these patients from being left behind, improving long-term health outcomes.
Using the Creyos Cognitive Assessment Platform for Early Detection
The Creyos Dementia Assessment and Care Plan is a comprehensive suite of digital cognitive tests designed for early dementia detection. Sensitive and scientifically validated, this assessment gathers both objective and subjective data for confident decision-making.
This protocol includes:
- A quick cognitive screen that takes less than five minutes to determine if cognitive impairment is present
- An assessment battery with domain-specific online cognitive tasks and questionnaires that take under 20 minutes to complete, and can be delivered remotely or in-clinic
- A prepackaged cognitive care planning tool that sets the foundation for personalized treatment plans
When the individual domains are scored, providers can identify if a patient’s weakest scores correlate with a suspected diagnosis. Rather than simply noting that impairment is present, there is clearer guidance relating to the specific impairments linked with neurocognitive disorders, including MCI and dementia. Once a diagnosis is made, the cognitive tasks can be used to monitor the effectiveness of treatment.
Clinicians don’t need hours of training to implement these tests—results are instantly scored and uploaded into an easy-to-interpret report. Instead of adding to the costly administrative burden, our assessment tools streamline cognitive testing into your processes.
Over the course of three years, Creyos Health provided the cognitive assessment tools for the world’s largest dementia trial. During this time, thousands of people remotely participated in online screening, gathering high-value data with low effort.
On a clinical level, our assessments helped Yukon Neurology see an average of 30 patients daily and complete 10 neuropsychological exams per week—without exhausting providers.
Staying On Top of Dementia Screening
To prepare for the oncoming boom of dementia patients, clinics and healthcare organizations can benefit from proactively implementing standardized cognitive care solutions. With scientifically backed tools for early detection, providers can refine their systems to consistently provide quality treatment without adding to administrative and financial burdens.
Reviewed by Sydni Paleczny, Staff Scientist
Sydni earned her MSc in Neurosciences at Western University under Dr. Adrian Owen. Her research explores neuropsychological outcomes after cardiac surgery, with interests in cognitive neuroscience, critical care, and brain health. At Creyos, she supports scientific validity, health technology, and ongoing research.