Navigating the Cognitive Screening Toolbox: Dustin Hammers, PhD

WATCH TIME: 6 minutes

"We are hoping that this is the first step in many studies that are starting to establish the validity of these types of measures that can be used in primary care settings to increase the rates of cognitive screening."

To make an accurate diagnosis of Alzheimer disease (AD), clinicians have typically relied on diagnostic tools combined with medical history and other information, including neurological exams, cognitive and functional assessments, brain imaging, and cerebrospinal fluid or blood tests. Some of the more traditional cognitive, functional, and behavioral tests include the Mini-Cog, Mini-Mental State Exam, Montreal Cognitive Assessment, Functional Activities Questionnaire, and Neuropsychiatric Inventory Questionnaire, among others. Over time, there have been efforts to incorporate more digital assessments, such as the Linus Health Digital Clock and Recall (DCR).

At the 2023 Alzheimer’s Association International Conference (AAIC), held July 16-20, in Amsterdam, the Netherlands, several presentations focused on the performance of these assessments and how they might be used in clinic. Led by Dustin B. Hammers, PhD, one such study found the DCR to be feasible, takes less time to administer than MoCA or the St. Louis University Mental Status assessment, and had concordant results with these more established tools in detecting cognitive impairment. A comparison between the impaired DCR scores (0-3) and impaired MoCA total scores produced 76% concordance. A subsequent analysis using MoCA total score paired with low DCR Delayed Recall performance revealed increased concordance (81%).

The DCR has been slowly introduced in recent years, with several published papers that have highlighted its quick and effective model. Although there are several traditional methods of cognitive screening, there is no gold standard, and oftentimes institutions vary in which assessments should be used. Hammers, an associate professor of neurology at the Indiana University School of Medicine, sat down with NeurologyLive^® to talk about the inconsistencies with cognitive screening, and how digital tools like the DCR may alleviate the process. In addition, he spoke about the results from the study and how they are applicable to real-world settings.

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REFERENCE
1. Hammers DB, Fowler N, Brosch J, et al. Comparative performance of the Digital Clock and Recall (DCR) test, Montreal Cognitive Assessment (MoCA), and Saint Louis University Mental Status (SLUMS) among patients in primary care. Presented at: 2023 Alzheimer’s Association International Conference; June 16-20; Amsterdam, Netherlands. Abstract 79034