Detecting Early Cognitive Decline

Cognitive decline is on the rise. The World Health Organization estimates that about 50 million people have dementia worldwide, with Alzheimer’s disease the most common form. In fact, according to the Alzheimer’s Association, an estimated 6.7 million Americans 65 years and older are living with the disease in 2023, with 73 percent of them 75 or older.

Individuals who are at increased risk of dementia include those who are overweight, have diabetes, hypertension, or lead a sedentary lifestyle. While screenings that can show signs of these chronic diseases exist, there currently isn’t a standard of care for being screened or tested for cognitive decline. However, according to Rannon Ching, PharmD and President/Chief Pharmacy Officer of Tarrytown Pharmacy in Austin, Texas, cognitive testing has the potential to reinforce community pharmacy as a driving force for preventative health services.

“The more pharmacists can educate their patients and local providers about the benefits of early detection of cognitive decline will only lead to better patient outcomes and higher quality of life,” Ching said. “I would recommend thinking about what positive impact you can have on your community by offering such a ground-breaking and needed service.”

You can get a head start in testing for early cognitive decline so your patients will be able to take action to modify underlying risk factors. The risk factors include diabetes, heart health, hearing or vision loss, obesity, and sleep disorders. The screenings rely on paper-and-pencil tests and measure attention, executive function, and memory. However, this can be limiting, so a new cognitive assessment device called Cognivue was born.

Cognivue is a computerized, cognitive screening based on FDA-cleared technology. It’s available as two different products:

Cognivue Clarity is a 10-minute, self-administered test that can be done in a medical facility. It weighs less than eight pounds, folds up like a laptop, and it evaluates six cognitive domains: abstraction, delayed recall, executive function/attention, language/naming, memory, and visuospatial ability.

The clinical scoring is:

75 or greater: normal cognitive function

51-74: low cognitive impairment

50 or less: moderate to severe cognitive impairment

Cognivue Thrive is a 5-minute, self-administered test and can be done in a pharmacy setting. The device can be folded easily and transported to different areas of an ambulatory care setting or community pharmacy. It evaluates executive function, memory, and visuospatial ability. It also includes a report with scores for three cognitive domains, and a letter that can be shared with the patient’s healthcare provider.

“We have had success and a lot of positive feedback with providing cognitive screenings,” Ching said. “The next step of our process is to expand the access of the test by working on finding medical insurance reimbursements for providing the screening and the interpretation. Right now, that looks like partnering with a physician who can bill Medicare and commercial insurances, but in the future, we’d like to see the ability to bill directly as the pharmacy.”

According to the Alzheimer’s Association, adding cognitive screenings to your community pharmacy can provide numerous benefits for you and for your patients.

Benefits for patients:

  • Receive the most benefit at the earliest point possible from treatment options
  • More time to plan for the future
  • Lessened anxieties about unknown problems
  • Increased chances of participating in clinical drug trials, helping advance research
  • Opportunity to participate in decisions about care, transportation, living options, financial, or legal matters
  • Time to develop a relationship with doctors and care partners
  • Benefit from care and support services, making it easier for them and their family to manage the disease

As the demand for cognitive screenings continues to rise, implementing Cognivue in your independent pharmacy will enable you to differentiate your business and attract new customers. With this service in your pharmacy, you will also strengthen referrals with local physicians by making it available to their patients while also complementing  in-store sales of supplements for brain health.

Cognitive screenings will contribute to the services you currently offer in your pharmacy:

Your patients can be screened without having to make an appointment at a doctor’s office or a separate testing facility.

Early detection
Early assessment is important because dementia can take years to present itself. Cognitive impairment can be an early sign of dementia or other neurological disorders. By offering screenings, you can assess brain health and promote earlier interventions, which can slow down or even reverse the impairment.

Impartial results
Tests like Cognivue Thrive eliminate healthcare provider bias and offer reliable and consistent results.

Proactive patients
When you engage patients in the testing process, you can educate them on controllable risk factors that affect cognitive function. When your patients are engaged in their health care, they’re more likely to stick to their treatment plans.

Doctor referrals
Your patient’s cognitive screening report is routinely provided to the patient’s primary care physician. This may lead to more doctor referrals.

With cognitive screenings at the point of care, you will be provided a new, non-dispensing revenue stream. Plus, with a baseline report, you’ll be able to schedule follow-up screenings and recommend protocols that may include treatment.

Improved workflow
Once you offer more clinical services in your pharmacy, you’ll attract more patients. With more patients, you’ll bring in more revenue and reduce the burden on primary care physicians. You’ll also free up resources for other healthcare services.

From the Magazine

This article was published in our quarterly print magazine, which covers relevant topics in greater depth featuring leading experts in the industry. Subscribe to receive the quarterly print issue in your mailbox. All registered independent pharmacies in the U.S. are eligible to receive a free subscription.

More articles from the December 2023 issue:

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