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Enhancing early detection of cognitive impairment in primary care with the TabCAT-BHA
Breithaupt AG, Sideman AB, Goode C, Hill-Sakurai L, Premkumar M, Scheffler AW, Chodos A, Tsoy E et al.. Alzheimer's & dementia : the journal of the Alzheimer's Association, 2025-07-01
Topic: Risk, prevention and care in population studies
Plain-language summary
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.
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APA 7th
Breithaupt, A. G., Sideman, A. B., Goode, C., Hill-Sakurai, L., Premkumar, M., Scheffler, A. W., et al. (2025). Enhancing early detection of cognitive impairment in primary care with the TabCAT-BHA. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1002/alz.70437
Vancouver
Breithaupt AG, Sideman AB, Goode C, Hill-Sakurai L, Premkumar M, Scheffler AW, et al. Enhancing early detection of cognitive impairment in primary care with the TabCAT-BHA. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2025. doi:10.1002/alz.70437. PMID: 40613257.
BibTeX
@article{breithaupt2025-40613257,
author = {Breithaupt, A. G. and Sideman, A. B. and Goode, C. and Hill-Sakurai, L. and Premkumar, M. and Scheffler, A. W. and Chodos, A. and Tsoy, E. and others},
title = {{Enhancing early detection of cognitive impairment in primary care with the TabCAT-BHA}},
journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
year = {2025},
doi = {10.1002/alz.70437},
pmid = {40613257},
url = {https://doi.org/10.1002/alz.70437}
}
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Key findings
- PCPs initiated cognitive screening using the TabCAT-BHA, administered by medical assistants, with results integrated into the electronic health record.
- 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).
Study details
- Evidence strengthLow
How this study scored 48/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 28 of the 58 points we could judge it on, which is 48 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & dementia : the journal of the Alzheimer's Association) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40613257) |
| Free to read | 2 / 2 | Free to read |
| Points | 28 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 28 of the 58 points we could judge it on is 48 out of 100. |
| Total | 48 / 100 | — |
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