With technology playing an increasing role throughout healthcare, leading dementia expert Dr Naji Tabet discusses its growing importance in early-stage dementia detection
Through the use of technology, the potential for patients in both primary and secondary care to have dementia detected at an earlier stage than ever before is being realised.
With the development of the Cognetivity platform, the first entrant to the market in using AI to conduct rapid cognitive analysis and can be completed by patients remotely, is supporting medical professionals by making the process quicker and simpler through the use of digital.
The platform is currently in trial as part of a clinical study to screen patients for signs of cognitive impairment at Sussex Partnership NHS Foundation Trust, under the guidance of Dr Naji Tabet.
The study has seen people taking Integrated Cognitive Assessment (ICA) tests both in-person and remotely through using an iPad, and is expected to be concluded within the next three months.
However, Dr Tabet – an honorary consultant at the Trust and highly-respected figure in dementia studies, who has previously led clinical trials in advancing potential treatments for Alzheimer’s disease – already sees the potential for its use both remotely and in medical settings.
“Technology can be very important for screening in primary care and simplifies the pathway of referral to secondary care assessment services,” says Dr Tabet, also director at the Centre for Dementia Studies at Brighton & Sussex Medical School.
“There is more potential for treatment through using such early-stage tests. By being able to diagnose people earlier, it opens the door to hopefully earlier treatment. That treatments current and future may work best, and may only work, in the early stages.”
In a medical environment, the use of digital assessment platforms such as Cognetivity can be particularly effective in relieving pressure on already stretched resources, says Dr Tabet.
“If you go to a GP surgery and say you’ve got a memory problem, the GP may use some very brief screening tools, and more likely than not the patient will be referred,” he says.
“A GP needs screening that is easy to do – it is impossible to spend 30-45 minutes doing this with a patient, a GP does not have that time. Their time is valuable and they are under pressure.
“This platform can be completed in five minutes while you’re waiting for your appointment, simply a patient can be handed the iPad to complete the assessment, there and then.
“Once referred to secondary care, it can determine which patients are seen first. It’s sometimes good to use simple tests to prioritise investigation.
“Dementia diagnosis is very labour intensive, there is a need for a brain scan, blood test, may be ECG, completion of cognitive assessment by a specialist nurse, psychologist, or occupational therapist. This assessment can take several hours, which can often be too much for a patient in one day, so they need another appointment.
“Through the use of this platform and technology, the cognitive testing process is simplified.”
And in addition to completion of the test in a medical environment, its potential for remote use is equally compelling to medical professionals and patients alike.
“You don’t need a 45-minute clinic appointment to do a cognitive assessment if a person can complete the test at home. Patients may be monitored remotely and invited back to the clinic if results indicate a deviation from what is expected for that particular patient, ” says Dr Tabet.
“We’re collecting evidence in the real world, to supplement data collected from earlier clinical trials, and this is very important.
“The study is assessing patient acceptability of the platform and its role as a remote assessment tool. Patients can complete the digital assessment on their own without the presence of a professional. If they can access this on an iPad, then this will impact positively on follow up decisions”.
Technology can be a valuable asset in the field of dementia, with digital-based cognitive tests helping to advance diagnosis and care.
“It is a good thing that AI is integrated into the digital platform, it’s very helpful to gather information on a particular individual as an individual and over time, rather than simply comparing them to the norm,” says Dr Tabet.
“If we are gathering information on a person and they are, for example, scoring 80 per cent and then that suddenly drops to 70 per cent, then that is meaningful.
“A great advantage of digital cognitive assessments such as Cognetivity ICA is that there is no bias in relation to language, culture or education. With some tests, the more educated you are, the better you do.
“Another advantage is that the cognitive tasks cannot be learnt. Inevitably for patients with mild cognitive impairment or mild dementia, there is a tendency to remember the answer to some of the questions when you take the test repeatedly..”
With the clinical study at the Trust now well underway – “lockdown thwarted some of our activity, but it’s picking up now,” says Dr Tabet – the findings could help pave the way to the more widespread adoption of the digital platform solutions in the NHS.
“We complete a wide range of research and studies focused on the quality of life of people with dementia, and the use of technology is absolutely important in the future,” he adds.
