A five-minute cognitive assessment, known as 5-Cog, significantly improves dementia diagnosis and care in primary care settings, according to a recent clinical trial funded by the National Institutes of Health (NIH).
The 5-Cog system, which includes three metrics to test memory recall, cognitive-gait connection, and symbol-picture matching, was tested among 1,200 predominantly Black and Hispanic older adults who presented to primary care with cognitive concerns. The assessment is easy to perform, quick, and unaffected by reading level or ethnic/cultural differences among patients.
Patients who received the 5-Cog assessment were more likely to receive dementia-related care within 90 days compared to those who received standard care. This included new diagnoses of dementia or mild cognitive impairment, further assessments, medications, or specialist referrals. The findings suggest that adopting the 5-Cog system could reduce barriers and improve dementia follow-up care in primary care settings.
Cognitive impairment is often challenging to diagnose in busy primary care settings, leading to underutilization of beneficial care plans. This underdiagnosis is even more prevalent among older Black and Hispanic patients compared to white patients, making the 5-Cog tool potentially more valuable for these populations.
The study was funded by NIH’s National Institute of Neurological Disorders and Stroke (NINDS) and National Institute on Aging (NIA) in collaboration with the Consortium for the Detection of Cognitive Impairment, Including Dementia (www.detectcid.org). The research was published in Nature Medicine on June 4, 2024. ClinicalTrials.gov identifier: NCT03816644.
References
Verghese J, et al. Non-literacy biased, culturally fair cognitive detection tool in primary care patients with cognitive concerns: a randomized controlled trial. Nature Medicine. 4 June 2024. DOI: 10.1038/s41591-024-03012-8.
