Evidence map›Paper›PMID 40877780›Full record

ArticleBMC primary care2025

An innovative health systems approach to support early detection of cognitive impairment in primary care - the brain health navigator.

Jared R Brosch, Diana Summanwar, Nicole R Fowler, Dustin B Hammers, Anthony J Perkins, Anna Higbie, Kristen Swartzell, Deanna R Willis

Abstract read
In one paragraph

Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Article
  2. Bridging the diagnostic gap: Expanding dementia care navigation for timely diagnosis.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
  3. Brain health care accelerator: A primary care-centered model for scaling dementia diagnosis and care.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
  4. Brain health navigation in a large integrated healthcare system.The journal of prevention of Alzheimer's disease · 2026
    Article
  5. Review
  6. Review
  7. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jared R BroschDepartment of Neurology, Indiana University School of Medicine, 355 West 16th Street, STE 4700, Indianapolis, IN, 46202, USA. jbrosch@iu.edu.
Diana SummanwarDepartment of Family Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
Nicole R FowlerDepartment of Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
Dustin B HammersDepartment of Neurology, Indiana University School of Medicine, 355 West 16th Street, STE 4700, Indianapolis, IN, 46202, USA.
Anthony J PerkinsDepartment of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
Anna HigbieIndiana University Center for Aging Research, Indianapolis, IN, 46202, USA.
Kristen SwartzellDepartment of Family Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
Deanna R WillisDepartment of Family Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients and providers experience barriers to early detection of mild cognitive impairment (MCI) and dementia. We developed a new primary care-based role, the Brain Health Navigator (BHN), who is trained to assess patients for cognitive impairment, identify addressable causes, suggest appropriate diagnostic testing, connect patients to resources, and assist patients in accessing disease-modifying treatments and dementia care management. This study describes the BHN role, the feasibility of implementing the BHN in Primary Care (PC) clinics, and the initial patients' outcomes for those who saw the BHN.

methodsPatients ≥65 years were screened with a Digital Cognitive Assessment (DCA) in seven PC clinics from June 1, 2022, to May 31, 2023. Patients who scored likely cognitively impaired or borderline for impairment were eligible for referral to the BHN. Clinics and providers could determine if referrals were automatic or on a patient-by-patient basis. The BHN encounter included a comprehensive assessment of standardized tools and suggested laboratory and imaging studies to facilitate the diagnostic process and connect patients to resources, care and treatment, and research opportunities.

results466 of 861 patients with likely impaired or borderline impaired DCA results were referred to the BHN.More patients with likely impaired scores (62.7%) were referred to the BHN compared to those with borderline scores (47.6%). Of the 466 referred patients, 28.9% with likely impaired scores and 23.5% with borderline scores completed a BHN visit. Patients who were seen by the BHN had a significantly higher likelihood of receiving a new diagnosis of MCI than patients who did not see the BHN and were more likely to have orders for diagnostic tests, such as vitamin B12 thyroid function and Magnetic Resonance Imaging of the head and neck. Referrals to both neurology and neuropsychology were significantly more common among patients who completed the BHN visit.

conclusionsA BHN enhances follow-up care and monitoring for patients with abnormal cognitive screening tests. A BHN visit increases the rate of evidence-based diagnostic evaluation for MCI and dementia in PC.

trial registrationThis study was designated as exempt by the Indiana University Institutional Review Board (#15281).

Indexed as

Cognitive DysfunctionDementiaPrimary Health CareAgedAged, 80 and overEarly DiagnosisFeasibility StudiesFemaleHumansMaleReferral and ConsultationAlzheimer’s diseaseCognitive screeningDementiaDigital cognitive assessmentDisclosure of diagnosisMild cognitive impairmentNurse navigatorPrimary careScreening

Identifiers

PMID40877780
PMCPMC12395694

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.