Dementia is an umbrella term for conditions characterized by a decline in memory, reasoning, and thinking skills. The Alzheimer’s Association reports that one type of dementia, Alzheimer’s disease, affects 33.4% of people aged 85 or older in the U.S.
As our population ages, there will be greater demand for cognitive testing, including mild cognitive decline and early dementia assessment. Fortunately, if dementia is caught in its earlier stages, it is more likely that a patient's symptoms can be lessened.
In this article, we'll discuss who should be tested for dementia, what kinds of tools are available to screen for signs of mild cognitive impairment (MCI), and how primary care providers can ease the burden on an overwhelmed healthcare system as more patients age. By being aware of the right tools and how to use them, clinicians can equip themselves to screen patients more effectively and diagnose dementia earlier.
Who Should Be Evaluated for Dementia?
So, what are the symptoms of dementia? As a primary care physician, here's what to look out for when assessing patients. Signs of dementia may include:
- Disruptive memory loss
- Difficulty planning or problem-solving
- Difficulty completing familiar tasks
- Challenges with determining time or place
- Struggles with images and spatial relationships
- New problems with spoken or written vocabulary
- Misplacing things and losing the ability to retrace steps
- Decreased or poor judgment
- Reluctance to work or withdrawal from social activities
- Mood swings and personality changes
Typical Demographics
Typically, those who may receive cognitive screening for dementia include anyone over 65 years old. According to the Alzheimer’s Association, about 7.2 million Americans in this age group are experiencing Alzheimer’s disease in 2025.
While it's true that age is the greatest risk factor for dementia, and people who are over 65 years old are more susceptible to developing these conditions, that doesn't mean younger people can't be affected as well. In fact, early-onset dementia has been diagnosed in patients as young as 30 years old. Although less affected by cancer than dementia in older adults, being aware that younger patients may also be affected can help clinicians detect early signs of the disease.
Preventive Care for Seniors
Some providers may opt to include cognitive testing as part of routine senior care for earlier detection and preventative care.
Preventive care for dementia usually focuses on a patient's modifiable risk factors. These include sleep quality, proper diet, physical activity, not smoking, and staying socially and mentally active. Patients who address these modifiable risk factors have a better chance of slowing or protecting against age-related cognitive decline.
Additionally, telehealth and computerized assessments may be key to helping patients track their symptoms and improve their cognitive health. One large clinical trial delivered Internet-based lifestyle interventions and assessments to over 6000 older adults, demonstrating that online strategies to prevent cognitive decline are feasible for many patients. The benefits potentially include better quality of life, reduced emergency visits, and decreased caregiver fatigue.
What Are Some Traditional Cognitive Tests for Dementia?
There are many tools for assessing dementia available, but only a few of them are scientifically validated. Here is a brief list to get started:
- Mini-Mental State Examination (MMSE): Used to assess advanced deficits in cognitive function and typically administered by pen and paper.
- Mini-Cog: Combines a recall test and a clock drawing test to assess memory and thinking skills, helping to determine whether further testing is warranted.
- Clock drawing test: This test assesses executive function and visuospatial function by instructing patients to draw a clock, which is then manually evaluated by a trained professional.
- Montreal Cognitive Assessment (MoCA): Evaluates spatial awareness, naming, short-term memory, language, executive function, and attention.
- Saint Louis University Mental Status (SLUMS): Measures attention, delayed and immediate recall, calculation, executive function, visuospatial ability, and extrapolation skills.
These traditional screeners can play a major role in the diagnosis of dementia, but they have their limitations. Modern digital cognitive assessments provide an accessible and effective alternative for providers who look to accurately screen for potential cognitive impairment in primary care.
Digital Cognitive Assessments for Better Dementia Testing
While the differences between pen-and-paper cognitive function tests and their computerized counterparts may seem superficial, the benefits of digital testing can potentially lead to an earlier—and more detailed—diagnosis. Digital tests can provide greater efficiency, with the remote capabilities of the tests improving accessibility, leading to fewer missed appointments.
On the other hand, routine computerized tests are fast, accurate, and sensitive. They’re flexible enough to be easily administered in primary care clinics or can be taken from the comfort of a patient's home. This can significantly reduce the time each appointment takes and remove any travel concerns and other potential in-clinic stressors for the patient.
Digital tests can also be randomized so they can't be memorized. When a patient is given routine repeatable tests over a period of time, physicians gain the longitudinal data needed to monitor for both current impairments and objective decline over time, assisting with making an early and accurate diagnosis. Creyos assessment reporting offers clear and easy-to-interpret results to visualize change over time and determine the effectiveness of a care plan.
The Creyos Dementia Assessment and Care Plan
The Creyos Dementia Assessment and Care Plan is a comprehensive testing battery that gives providers a practical and accurate solution for improving cognitive care.
The complete dementia assessment includes:
- A quick cognitive screener for initial detection of potential impairment
- A full assessment of cognition and other dementia criteria to help providers make a more precise diagnosis
- A prepackaged cognitive care plan to ensure patient safety and caregiver support
These tools work together to give providers an all-in-one platform for precisely detecting impairment and monitoring cognition.
Recommended Cognitive Assessment Tools and Care Experiences
Before physicians start implementing cognitive screening tests for dementia, they should ensure they’re using accurate assessment methods that fit into their workflows.
Considerations When Choosing Cognitive Assessment Tools
Scientific validity is one of many critical considerations when choosing a cognitive assessment tool. It is also important to look at how cognitive assessments fit into existing workflows and how they can save time. Flexibility in administration can make tools effective and easy to implement into care workflows while still being convenient for patients. Whether it’s at a yearly in-clinic visit or follow-up assessments to address concerns, it’s important to analyze a tool’s ability to be administered quickly and efficiently, without sacrificing accuracy. Creyos assessments were built from the ground up to fit seamlessly into provider workflows.
The Role of Cognitive Assessment Tools in Primary Care
Primary care physicians are often who a patient goes to first when they want to discuss their cognitive health. When it comes to patients experiencing dementia-like symptoms, the goal is to rule out other causes of cognitive impairment (such as severe depression, medication effects, or delirium) and find out if the patient has dementia.
Evidence-based cognitive assessments can indicate more accurately whether there is justification for an initial dementia diagnosis or a need to refer a patient to a specialist to find out more about their cognitive impairment. Some digital cognitive assessment platforms, like the Creyos dementia assessment, also include tools to create and follow a care plan.
When to Refer Patients to a Specialist for Dementia
Traditionally, patients with suspected dementia are referred to a specialist as soon as possible, but the truth is, specialist appointments can take months to arrange. In a survey, 55% of primary care providers reported that there were too few specialists in their area to meet demand.
Digital cognitive assessments empower primary care providers to get more answers earlier in a patient's health journey, speeding up the process and helping to determine next steps as early as possible. Early detection is key when it comes to progressive conditions like dementia.
Using Creyos cognitive assessments or other digital assessment tools can offer additional insights and assist a primary care provider in identifying signs of dementia and determining if a referral is required. Providers using Creyos have seen increased patient retention as a result.
For example, primary care physicians often see older patients who are concerned about declining cognition but are unable to distinguish normal aging from early signs of dementia. Quick digital assessments can compare the patient’s performance to thousands of other people the same age and determine if the performance is outside the expected range or not. Often, this will reveal that performance is actually normal, reducing the need for unnecessary referrals that contribute to long wait times for specialists.
If assessments do identify mild cognitive impairment or potential dementia, providers can take action, such as ordering lab tests, ruling out reversible causes of impairment, and reviewing family history. In many cases, they refer patients to a specialist for confirmation and a more detailed assessment. Among their many roles—whether they are a neurologist, neuropsychologist, psychiatrist, geriatrician, or other expert—a specialist can provide more detailed insights into the multiple causes of dementia by:
- Ruling out other causes for cognitive deficits
- Conducting more testing on the nature and severity of deficits
- Interviewing the patient and family members
- Using brain imaging or biomarker tests
After a patient sees a specialist, primary care physicians can continue to be their main healthcare ally by supporting them with regular cognitive assessments, a cognitive care plan, and additional health resources to ensure they get the best care possible. Continuity of care can lead to better patient outcomes.
Final Thoughts
Primary care physicians are the frontline against the rise of cognitive decline as our population ages. While specialists are trained to get to the root of dementia symptoms, it can take months for patients to book an appointment. And time is limited, especially when it comes to delivering effective treatment for dementia before it progresses.
Dementia isn’t all or nothing and often begins with MCI. For a faster process, primary care providers can use computerized cognitive assessment tools, like those offered through Creyos Health. This may make the difference between an early or late diagnosis—leading to better patient quality of life down the road. With the help of easy-to-administer computerized cognitive tests that detect and track signs of early dementia, you'll be able to provide your patients with better care and ease the overall burden on the healthcare system.
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.