The article "Non-literacy biased, culturally fair cognitive detection tool in primary care patients with cognitive concerns: a randomized controlled trial" presents the findings of a study on the efficacy of the 5-Cog paradigm, a brief and culturally fair cognitive assessment tool, paired with clinical decision support, in improving dementia diagnosis and care in primary care settings. The study included 1,201 participants, predominantly from racial/ethnic minorities and socioeconomically disadvantaged backgrounds, with a mean age of 72.8 years, 72% of whom were women, and 94% were Black, Hispanic, or Latino. The results demonstrated that the 5-Cog paradigm significantly improved dementia care actions, including new diagnoses of mild cognitive impairment (MCI) or dementia, and orders for investigations, medications, or specialist referrals, with a threefold increase compared to the control group (OR 3.43). Notably, no serious intervention-related adverse events were reported.

The tool's non-literacy biased and culturally fair nature makes it suitable for diverse patient populations, addressing a significant gap in dementia care for historically marginalized groups. Embedding the 5-Cog tool in electronic medical records can assist primary care providers in making informed dementia care decisions, promoting more consistent follow-up actions based on cognitive test outcomes. For future research, it is essential to investigate the long-term impact of the 5-Cog paradigm on patient outcomes, conduct economic evaluations to assess cost-effectiveness, and expand studies to include asymptomatic older adults and diverse healthcare settings to validate generalizability. Exploring the synergy between the 5-Cog paradigm and other dementia care interventions, such as caregiver support programs and community-based resources, along with developing digital versions for telehealth contexts, can further optimize its potential to improve dementia care outcomes in diverse and underserved populations.

Reference:
Verghese J, Chalmer R, Stimmel M, et al. Nat Med. Epub ahead of print. Abstract