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Cognitive Maintenance: Making the Case for Cognitive Assessments in Routine Healthcare

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For years, healthcare has been moving toward a more proactive, individualized approach to assessing and treating patients. The rise of telehealth and remote monitoring
has encouraged this shift across many specialties—but such positive changes in the cognitive care realm have lagged. Despite increasing awareness about mental health and cognitive care, there has been a lack of meaningful evolution in technology and attitudes supporting a more proactive care approach.


Interested in learning more about why and how to improve cognitive maintenance care in your practice?

Download our eBook:Cognitive Function: A Core Component of Routine Healthcare

A large part of the problem lies in the nature of our healthcare system. By design, it tends to be reactive instead of proactive, and patients often only visit their doctors when they have health problems to address. On the surface, the reactive approach seems less costly: Healthcare services are only administered when needed, saving limited resources. However, this reactive approach actually has the opposite effect and typically results in increased healthcare costs. When taking a reactive approach to brain health, action may not be taken until symptoms are obvious. Unfortunately, by the time a diagnosis is finally made, it’s often too late to reverse the condition.

In contrast, a proactive approach may identify potential problems before a patient’s quality of life is impacted. And that doesn’t just apply to cognitive decline and neurological disorders—a proactive approach may also get ahead of mental health issues, which often impact cognition. A proactive healthcare stance gives clinicians the tools they need to measure and compare cognitive functioning to determine if there is a significant change over time.

Clinicians have embraced early detection measures like cancer screening and longitudinal methods like heart disease monitoring, which have proven to be far more successful at saving lives than most reactive treatments. When it comes to the brain, though, it is rare to take measurements to assist in early detection, despite evidence that seeing the warning signs of cognitive decline during routine healthcare can dramatically improve patient outcomes.

Many patients and clinicians expect an annual checkup and blood tests for general wellbeing, so why are brain health and cognitive function exempt from this proactive approach?

 

The Current Standard of Care in Cognitive Maintenance

It’s challenging to evaluate the current standard of care when it comes to cognition in regular healthcare, because the care simply doesn’t exist. There is no standard of practice that clinicians are expected to implement. Cognitive health assessments are only performed when there is a suspected problem, which often means it is too late to provide a solution. Part of the reason for this gap is that there have been no tools to easily and effectively perform regular cognitive assessments. In addition, the existing tools are not sensitive or reliable enough to detect changes that may signal early warning signs of decline.

Comprehensive cognitive assessments are costly, resource-intensive, and time-consuming, and therefore not sustainable to perform regularly if not needed.

The currently available instruments (e.g., the MMSE and MoCA) can help clinicians conclude that a patient is cognitively impaired, but it is typically in a binary manner—yes, they are impaired or no, they are not impaired. However, cognition is much more nuanced than that, as there is a broad spectrum of outcomes and varying levels of impairment. Cognition should be assessed and treated in accordance with each patient’s personal baseline and domains that are showing signs of impairment. By taking a proactive approach to cognitive care, clinicians can easily establish that baseline, identify specific cognitive domains of concern, monitor the patient over time, and enact a more comprehensive cognitive assessment when required.


 

Improving Cognitive Maintenance Healthcare

The only way to improve cognitive maintenance in healthcare is to regularly provide cognitive assessments. It sounds relatively simple, but there are a few reasons this likely isn’t happening within most practices:

  • Lack of awareness both from healthcare providers regarding how cognitive assessments are linked to patient outcomes and from patients regarding cognition as something that can be objectively measured.
  • Patient worry around what the subjective symptoms they are experiencing (e.g., brain fog) mean for the future.
  • Costs for both clinicians and patients. Clinicians are worried they cannot get reimbursed for regular cognitive assessments and therefore have to pass on the costs for these services to their patients, who cannot or will not pay for them.

 

It’s Time for a Change, with CBS Health

Cambridge Brain Sciences offers a scientifically validated and easy-to-use digital platform for assessing cognitive and behavioral health, giving clinicians the additional insights they need to deliver superior patient care. Over 25 years of research have led to the creation of the CBS Health online cognitive assessment platform. Using the CBS Health platform for cognitive maintenance, clinicians can provide improved patient care with assessments that:

  • Can be self-administered by patients in their own homes
  • Can be automated on a schedule
  • Provide scientifically validated cognitive data

 

CBS Health Platform

CBS Health allows clinicians to administer 12 core tasks of cognitive function as well as many standard questionnaires such as the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7) scale, Perceived Stress Scale (PSS), Rivermead Post-Concussion Symptoms Questionnaire (RPQ), and many more.

With a set baseline, clinicians can monitor patients consistently for performance stability and begin to track an objective indicator for cognitive change. In addition, numerous brain imaging studies have directly linked neural activity in specific regions with each task, giving clinicians the tools needed to connect performance with brain disorders and deficits. These cognitive maintenance healthcare tools allow clinicians to:

  • Initiate longitudinal monitoring with a reliable baseline to improve ongoing care
  • Generate easy-to-understand reports to improve communication with patients, family members, and caregivers
  • Enhance practice offerings with a solution that reduces administrative burden and is reimbursable
CBS Health makes it easy to incorporate cognitive maintenance care as a standard part of your healthcare practice to provide exceptional, personalized care to your patients.

Want to know more?

Download our eBook: Cognitive Function: A Core Component of Routine Healthcare

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