A recent proof-of-concept study conducted by researchers at Lund University reveals that a brief self-management digital cognitive assessment called BioCog effectively detects cognitive impairments. When used alongside blood tests, it can accurately identify clinical Alzheimer’s disease in primary care settings.
In primary care, the BioCog test achieved 85% accuracy in identifying cognitive impairments with a single cutoff, significantly outperforming primary care physicians, who had a 73% accuracy rate. Image credit: Miroslaw Miras.
Alzheimer’s disease stands as the leading cause of dementia, marked by amyloid beta accumulation, tau aggregation, and progressive neurodegeneration.
Clinical presentations of Alzheimer’s typically begin with subjective cognitive decline, where individuals report memory issues and other cognitive challenges, although formal cognitive tests may not yet indicate impairment.
This initial phase advances to mild cognitive impairment, which is characterized by objective cognitive symptoms, ultimately evolving into dementia marked by significant functional limitations in daily life.
Diagnosing Alzheimer’s in its early stages, especially in primary care, can be particularly challenging.
There’s a considerable prevalence of both misdiagnosis and missed diagnoses, with 20-30% of cases incorrectly diagnosed in specialist environments and about 40% in general practice when Alzheimer’s is not corroborated by biomarkers.
“The BioCog digital assessment, designed to allow patients to perform with minimal healthcare worker involvement, will enhance primary care physicians’ ability to investigate potential Alzheimer’s pathology early through blood tests,” stated the researchers.
“Primary care typically lacks the resources, time, or expertise to explore Alzheimer’s disease with the same thoroughness as specialized memory clinics.”
“This is where digital cognitive assessments can play a vital role.”
In contrast to the traditional pen-and-paper tests utilized for evaluating cognitive impairment, digital assessments offer a more comprehensive analysis.
They easily integrate novel variables and additional factors that were not previously measured.
“Most individuals experiencing memory loss first seek help at their local health center,” remarked Pontus Tideman, a doctoral student at the University of Rand and psychologist at Skone University Hospital’s memory clinic.
“Our new digital evaluations provide the initial objective insights needed, ensuring higher accuracy in identifying cognitive impairments related to Alzheimer’s disease.”
“This determines who should undergo a blood test that measures phosphorylated tau levels, which can reliably detect Alzheimer’s disease in the brain.”
Currently, these blood tests are available exclusively at hospital specialty and memory clinics.
In time, they are expected to be accessible in primary care; however, it is not intended for all patients with cognitive complaints to undergo blood testing.
Researchers assert the immense value of digital solutions, given the challenges of diagnosing Alzheimer’s during a typical 15-20 minute patient consultation.
This is where objective digital tools for assessing cognitive skills can significantly alter the diagnostic landscape.
“A distinctive feature of our BioCog assessments is their validation within primary care settings, unlike many other digital evaluations. These assessments are aimed at patients seeking treatment due to cognitive concerns, such as memory problems,” the researchers noted.
“The combination of digital assessments with blood test results can greatly enhance the diagnostic accuracy of Alzheimer’s disease.”
“The goal of this test is to simplify the process for primary care physicians.”
The BioCog test is detailed in a study published in the journal Nature Medicine.
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P. Tideman et al. Primary care detection of Alzheimer’s disease using self-administered digital cognitive tests and blood biomarkers. Nat Med. Published online on September 15th, 2025. doi:10.1038/s41591-025-03965-4
Source: www.sci.news
