Alzheimer Screening in Primary Care Feasible but Rare: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On June 5, 2025, we reported on a study published in the Annals of Family Medicine that assessed the feasibility and acceptability of implementing a digital cognitive assessment (DCA) for Alzheimer disease and related dementias (ADRD) screening into primary care.

The study

Researchers conducted a single-arm pragmatic clinical demonstration project in 7 diverse primary care clinics to test the implementation of the Linus Health Core Cognitive Evaluation and Digital Clock and Recall DCAs (Linus Health, Inc). The tablet-based assessment includes digital clock drawing, 3-word recall tasks, and a questionnaire about cognitive status. Scores range from 0-5, with 0-1 indicating cognitive impairment, 2-3 as borderline, and 4-5 showing no impairment.

Participating clinics developed customized workflows for implementing the assessment through structured planning sessions that determined when and how to administer it. The pragmatic design of the project gave participants the opportunity to refuse the digital assessment or to not finish if if started. Clinicians had the opportunity to decline offering the assessment at any encounter.

There were 16 708 eligible encounters during the 12-month study period (June 2022-May 2023), according to investigators.

The findings

• Of the 16 708 patients identified as eligible for screening, a total of 1808 digital cognitive assessments (10.8%) were completed by 1722 unique patients.

• More than one-half (55.3%) of eligible visits never offered the digital cognitive assessment because PCPs declined or the encounter was deemed out of scope.

• Among 1808 tests, 44.3% were categorized as unimpaired, 36.5% as borderline, and 13.7% as impaired.

  • Among participants who were categorized as impaired, 2.1% received a new diagnosis of ADRD, and 5.1% received a new diagnosis of mild cognitive impairment within 90 days of the digital cognitive assessment.

Authors' comments

"Digital cognitive assessments can be implemented in primary care, have utility for early detection, and could represent the first step in identification of patients who could benefit from ADRD disease-modifying therapeutics, care management, or other interventions to improve patient and family caregiver outcomes."

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