Can computer-based assessments help diagnose dementia early?

January is Alzheimer's Awareness Month, and Sunnybrook researchers are working to help physicians provide patients with timely and accurate dementia diagnoses.

As the Canadian population rapidly ages, the early diagnosis of dementia is becoming increasingly important. In particular, family physicians (FPs) will be called upon to administer lengthy cognitive assessments more often, straining their busy family practice schedules.

Led by Dr. Mary Tierney, director of the primary care research unit at Sunnybrook, a group of researchers are studying the feasibility of computer-administered cognitive assessments.

"While FPs believe in the importance of cognitive assessments, the limited time they have to complete them is a major obstacle. Computerized testing could be used to assist FPs in patient care, as long it is feasible in their older patients," says Tierney, who is also a professor in the department of family community medicine at University of Toronto.

To date, Sunnybrook researchers have administered the Computerized Assessment of Mild Cognitive Impairment (CAMCI) to 263 patients, aged 65 and older. Of the 259 patients that completed the assessment, 93 per cent were able to do so without any additional instructions beyond those provided at the beginning of the test. The main reason the patients needed additional instructions was lack of prior computer use.

"This shows that a computerized cognitive assessment could work well in a family medicine setting. For patients who have never used a computer before, an administrator can be present to help, and it is not necessary for that person to have any specific knowledge about the CAMCI or cognitive function," says Dr. Jocelyn Charles, a co-investigator on the study and chief of family medicine at Sunnybrook.

The next step in the study is to individually interview FPs regarding the usefulness of the computerized test report, and to compare patients' computerized test results with those from paper-based tests. The study continues until the fall of 2012.

Alzheimer's disease is the most common form of dementia, accounting for 64 per cent of all dementias in Canada. Symptoms of the disease include the gradual and ongoing decline of short- and long-term memory, along with changes in language abilities, mood, behaviour, judgment and reasoning.

In 2010, more than 500,000 Canadians were living with dementia, at a cost of about $22 billion per year. The number of people with the disease is expected to double within a generation to 1.1 million, and care costs could top $150 billion per year within 25 years.