Optimising Cognitive Screening in General Practice

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Within the next 5 - 10 years it is likely that sophisticated combination pharmacotherapy for Alzheimer's disease will become available. Once intervention agents are available that affect the underlying disease process, it will be critical to accurately identify those patients who are in the earliest stages of cognitive decline. That is, failure to detect cognitive decline at an early stage will reduce the effectiveness of the intervention and be costly to the individual and society. At the same time, the probability of falsely identifying an individual as having Alzheimer's disease needs to be reduced in order to avoid unnecessary testing, anxiety and distress, and expense. A sophisticated and highly flexible testing system to detect the earliest stages of memory impairment will be developed. The test will be administered over the web in a general practitioner's surgery enabling the collection of normative data on the population of greatest interest (elderly patients seeing their doctor). Voice recognition technology will be used in order to insure a user friendly environment. Stringent procedures to protect privacy will be employed. The test will be inexpensive and easy to take and will allow valid retesting so that it can be used as part of the routine health screening for the elderly. This will be a far more sensitive and specific indicator of the cognitive decline found in most neurodegenerative disorders such as Alzheimer's disease, and will enable general practitioners to be more confident in assessing their older patients. It will also reduce costly referrals by more accurately identifying those patients at risk. It is expected that the test will find acceptance amongst patients and their doctors and become a routine part of normal health screening for the elderly.