MyCog - Rapid detection of cognitive impairment in everyday clinical settings

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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 two cognitive measures drawn from the NIH Toolbox for Assessment of Neurological and Behavioral Function® and the Everyday Cognition self- and informant-report measures 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 African-Americans, a health disparities population. Our proposed project will 1) Create a standalone MyCog App using existing NIHTB cognition tests and Everyday Cognition 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 and determine its sensitivity in detecting early indicators of CI using an existing cohort (LitCog III) of well-characterized, ethnically and racially diverse adults ages 65- 85; 3) Evaluate the success of MyCog clinical implementation in primary care settings; 4) Optimize MyCog for use in clinical settings by adjusting scoring algorithms to maximize efficiency and incorporating features that facilitate clinical integration; and 5) if selected to do so, coordinate consortium-wide activities.