Enhancing early detection of cognitive impairment in primary care with the TabCAT-BHA

Abstract

INTRODUCTION

As dementia cases increase and new therapies become available, timely diagnosis is critical yet challenging in primary care. We evaluated the TabCAT-Brain Health Assessment (TabCAT-BHA) digital paradigm to assist with early detection and diagnosis.

METHODS

This implementation study involved 21 primary care providers (PCPs) serving 2733 eligible patients in a family medicine clinic. PCPs initiated cognitive screening using the TabCAT-BHA, administered by medical assistants, with results integrated into the electronic health record. The study assessed changes in PCP cognitive diagnoses, specialist referrals, and implementation metrics.

RESULTS

TabCAT-BHA was adopted by 95% of PCPs, who were more likely to diagnose cognitive disorders (adjusted odds ratio: 1.72, 95% confidence interval: 1.13–2.62, p = 0.01). Practice-wide diagnosis rates remained elevated after research support ended. PCPs reported increased confidence, reduced stress in diagnosing dementia, and preferred TabCAT-BHA over traditional assessments.

DISCUSSION

TabCAT-BHA was well accepted and sustained, offering a scalable solution for cognitive impairment diagnosis in primary care.

Highlights

• A digital test paradigm increased cognitive impairment diagnoses in primary care.
• Increased diagnoses across minority groups may mitigate healthcare disparities.
• Clinicians preferred the digital cognitive assessment over alternative tests.
• The paradigm decreased clinician stress and increased confidence around diagnosis.
• Integration with clinic staff workflow yielded high adoption and sustainability.