Neurosessments: Developing a quick, objective motor test to prompt cognitivetesting in primary care

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PROJECT SUMMARY/ABSTRACT Alzheimer’s disease (AD) is the leading cause of dementia in the United States, affecting one out of every nine older adults. However, Alzheimer’s disease and related dementias (AD/ADRD) can be difficult to diagnose, with physicians missing nearly half of all probable dementia cases. Rates of missed diagnosis are even higher among Black older adults. The majority of physicians do not regularly screen their patients with cognitive tests, due mostly to a lack of time during their face-to-face time with patients. Thus, there is a clear need for a quick, objective test that can be administered by medical staff prior to the physician’s time with the patient, which will prompt cognitive testing or a specialist referral for follow-up when there is concern for AD/ADRD. Since research has shown that motor regions in the brain are affected early in the progression of AD, the long-term goal of Neurosessments LLC is to develop a motor test that will help improve dementia detection in primary care that is appropriate for older adults from diverse backgrounds. Prior research by the Neurosessments LLC team has developed an experimental version of a motor test that can identify dementia, predict functional decline, and detect brain amyloid, regardless of the patient’s educational attainment, sex, or age. The overall objective of this Phase I SBIR is to adapt the original version of this motor test into a quick (<2 minutes) and easy to administer version called qBEANS (quick Behavioral Exam to Advance Neuropsychological Screening) for medical staff to use. The specific aims are to 1) determine the reliability and racial equity of a short version of the motor test and 2) develop a digital user interface for administering and scoring the motor test that is usable in a clinical setting. Achieving these aims will lead to a Phase II SBIR that deploys qBEANS within primary care offices and community health clinics to increase rates of cognitive testing and improve dementia detection. This proposal is innovative in its use of motor behavior to detect probable dementia in its early stages, and its development of tools for intended use in primary care. The commercialization plan is to sell single-use test kits to medical providers for use in primary care settings to annually screen adults ages 65 and older. Through routine screening, primary care providers will be able to identify individuals whose scores indicate possible dementia, informing providers of whether or not to perform additional cognitive testing or refer to specialists for possible diagnosis of AD/ADRD. The societal impact is that it will improve the rates of early dementia diagnosis, giving older adults and their families the gift of time to make decisions about treatment options, legal plans, personal care plans, and finances.