The 5-Cog Paradigm to Improve Detection of Cognitive Impairment and Dementia: Clinical Trial Protocol
Rachel Chalmer, Emmeline Ayers, Erica Weiss, Rubina Malik, Amy M. Ehrlich, Cuiling Wang, Jessica Zwerling, Asif Ansari, Katherine L. Possin, Joe Verghese
Abstract
Cognitive impairment related to dementia is under-diagnosed in primary care despite availability of numerous cognitive assessment tools; under-diagnosis is more prevalent for members of racial and ethnic minority groups. Clinical decision-support systems may improve rates of primary care providers responding to positive cognitive assessments with appropriate follow-up. The 5-Cog study is a randomized controlled trial in 1200 predominantly Black and Hispanic older adults from an urban underserved community who are presenting to primary care with cognitive concerns. The study will validate a novel 5-minute cognitive assessment coupled with an electronic medical record-embedded decision tree to overcome the barriers of current cognitive assessment paradigms in primary care and facilitate improved dementia care.