Shifting the brain health status quo to foster early intervention

June 22 2023

“There are very well-established preventive care practice models for many different systems. For example, breast and colorectal cancers; you start screening for these cancers very early on…Interestingly enough though, there's not something like that established for brain health. In order to prevent or delay cases in the future, we need to institute screening and intervention programs in the years before people show symptoms.” - Dr. Joyce Gomes-Osman, VP of Interventional Therapy at Linus Health

Embracing early detection as a priority has radically shifted many fields of healthcare - from cancer to cardiovascular disease.

Routine mammograms can detect breast cancer before tumors are large enough to feel or cause symptoms. It’s possible to intervene at a stage where the disease is easier to treat, reducing the risk of death for millions of women.

Lung cancer, similarly, can now be identified before someone even suspects they have the disease. Performing annual low-dose CT scans on people at high risk catches the cancer early, before it disrupts a person’s life and while treatment is much more likely to succeed. These scans lower the lung cancer death rate by 20 percent.

Despite its potential to change lives, early detection still lags behind in brain health. The good news is that it is now possible to detect cognitive impairment while the signs are so subtle as to be imperceptible, but routine cognitive testing is still rare. With the world on track to see a surge in cognitive care needs, the repercussions of embracing routine testing could be enormous.

Overcoming barriers to detecting cognitive issues early

Until recently, early diagnosis of cognitive issues wasn’t considered practical. 98 percent of PCPs agree that it’s important to diagnose mild cognitive impairment, but almost 60 percent report it is difficult to do.

Now, advances in neuroscience and AI have made it possible to screen efficiently, in a cost-effective way. Providers can detect cognitive impairment early enough to recommend lifestyle changes and health interventions that slow progression of cognitive impairment in some cases and protect overall brain health. It’s time to deploy this technology on a wider scale to streamline diagnosis and improve the outlook for people around the world.

Making proactive cognitive testing the new normal

Many older patients don’t exhibit obvious signs of cognitive impairment. At the moment, they may be reluctant to visit a doctor early, even if they do.

Routine mammograms and prostate screenings are widely accepted as important, but screenings for brain health aren’t there yet. Older adults concerned about cognitive issues often hide their concerns from providers; they fear receiving a diagnosis and associated stigma or accept cognitive impairment signs as part of aging.

To have a significant impact, cognitive testing must become a standard preventive measure for older adults. For this to happen, it must be more feasible than has historically been the case with paper-based tests. Assessments need to be easy to administer and capable of detecting issues early. Recent technological advances have made both possible.

The role of AI in early detection and intervention

PET scans are effective at picking up pathology that may lead to dementia, but they’re expensive to administer. And, because they usually come into play only when someone is experiencing overt symptoms and has already had to wait to see a neurologist, the status quo results in significant lost time before interventions begin.

Advanced cognitive assessments can now help triage patients needing specialist referrals more effectively and streamline the diagnostic pathway. Digital assessments from Linus Health, for example, have made it possible to bring process-based analytics into automated cognitive tests. These analytics used to require skilled neuropsychologists to observe and interpret patients completing cognitive tasks, limiting the scalability of the use of this method to gain rich insight into cognitive function. Now, iPads and AI are solving that problem.

The use of AI in early detection is far from unprecedented. Before we take a closer look at its role in brain health, let’s dig into another example.

AI improving outcomes – a case study

AI is playing a key role in the detection of colorectal cancer. Left untreated, flat polyps are more likely than others to develop into an aggressive form of cancer that spreads quickly. Unfortunately, as well as being more aggressive, they are also harder to spot. Researchers found that expert colonoscopists could identify only 37 percent of flat polyps. Fortunately, in the same dataset, an AI algorithm detected 79 percent. In other testing, the algorithm detected almost 100 percent of polyps.

Senior author, Professor Laurence Lovat (UCL Surgery & Interventional Science), said:

“Refining the AI is a significant step forward in the early detection of colorectal cancer and will lead to lower rates of missed cancers and vastly improve our capability to save lives.”

AI in brain health

In the field of brain health, AI is democratizing access to early detection for cognitive impairment and dementia too.

The Linus Health platform assesses a person's performance on a combination of clock drawing and word recall tasks. It is the only digital cognitive assessment that uses the process-based analytics to assess the process people take to complete cognitive tasks, along with the final output. By recording 100+ metrics during the approximately three-minute cognitive test, AI is able to detect subtle, imperceptible symptoms of cognitive impairment.

Modern technology is changing our approach to brain health. Adding an AI-based digital cognitive assessment to your patient’s annual wellness check-up is now easier than ever with quick, efficient testing methods using familiar devices. Plus, automated administration makes it so clinical staff can handle the cognitive testing process, reducing reliance on providers. With rising cognitive care demands as the population ages, it’s time to shift our approach to one that embraces cognitive screening and catches cognitive impairment before symptoms arise and impact people’s lives.