MyCog - Rapid detection of cognitive impairment in everyday clinical settings

Cognitive impairment (CI) and dementia are significant public health burdens that can have profound social and emotional effects on older adults. Early detection of CI is imperative in order to identify potentially treatable underlying causal conditions, and in cases where cure is not possible, to provide supportive services to minimize the effects of CI. While primary care and other clinical settings are ideal places for identifying CI, it frequently goes undetected. Available screening tools may be unsuitable for implementation in such settings because of their length, cost, or need for specialized equipment or highly trained administrators. Our project, MyCog: Rapid detection of cognitive impairment in everyday clinical settings, will create a brief, readily available, standard set of CI screening measures applicable for use in diverse settings and with diverse populations. Comprised of cognitive measures drawn from the NIH Toolbox for Assessment of Neurological and Behavioral Function, and implemented as a downloadable app, MyCog will be validated in a large sample of older adults (ages 65+) enrolled in “LITCOG III: Health Literacy and Cognitive Function among Older Adults”. Field testing MyCog within LITCOG III will allow validation in multiple clinical workflows, and in two health disparities populations: African-Americans and individuals with low socioeconomic status (SES). Our proposed project will 1) Create a standalone MyCog App using existing NIHTB cognition tests and self-/proxy report measures that will report screening results as either “No CI detected”, or ‘CI detected” and provide follow-up recommendations and guidelines for each outcome; 2) Validate MyCog (UH3 Phase) in primary care settings using an existing cohort (LITCOGIII) of well-characterized, ethnically and racially diverse adults ages 65-85 and determine it’s sensitivity in detecting early indicators of cognitive impairment will be evaluated; 3) optimize MyCog for use in clinical settings by adjusting scoring algorithms to maximiaze efficiency; and 4) if selected to do so, coordinate consortium-wide activities.