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Any primary care doctors have had a complicated relationship with tests designed to screen their patients for Alzheimer’s disease. Beyond recommending a few lifestyle changes—tweaks to diet, exercise, and sleep most would recommend anyway—there was little they could do to help patients with a confirmed diagnosis. 

As new drugs expand the options for treating and preventing Alzheimer’s, demand from older people worried about their mental fitness and seeking routine screening for Alzheimer’s and other dementia is expected to rise quickly. In anticipation, several commercial firms are racing to bring to market new digital screening tools that can detect warning signs that the disease could be developing. (Diagnostic tools, by contrast, are used to establish the presence of the disease, usually by detecting amyloid.) Many of these new screening tools use artificial-intelligence algorithms and can be administered by medical assistants without extensive training. They hold out the promise of inexpensive and noninvasive methods of screening people for Alzheimer’s. 

“Dementia is the number-one fear of people over 55,” says David Bates, CEO of Boston-based Linus Health, a digital assessment company. “You have drug companies that are about to be advertising their drugs. And you’re going to have commercials and marketing stoking that fear to drive people to ask for the drug. So you’re going to have this onslaught of demand in the health system. Primary care doctors will not be able to meet that demand. They’re going to get overwhelmed.”

PET imaging and tests of cerebrospinal fluid, which document the presence of amyloid beta plaques in the brain, are currently the gold standard for providing a diagnosis of Alzheimer’s. But these tests are too expensive and cumbersome to administer to meet the anticipated need for Alzheimer’s screening in large populations. Although blood tests that can flag the buildup of amyloid are beginning to emerge from the lab, they are not yet widely available.

For years, primary care physicians have instead relied on pen-and-paper cognitive tests to screen patients with mild cognitive impairment, but these tests can take 20 to 30 minutes to complete and require a trained administrator.  The “reality is primary care doctors don’t have that time,” says Brad O’Connor, CEO of CogState in Australia.

A test sold by Linus Health combines an established pen-and-paper test based on a simple drawing test with added artificial intelligence to make it easier to administer and more powerfully analytic. In the test, a patient is asked to draw a clock with the clock hands indicating a specific time. The task engages disparate areas of the brain involved in motor, visual, analytical and other functions that are often impaired by dementia. 

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