{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:19:25Z","timestamp":1792113565910,"version":"4.4.0"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["UG3\/UH3NS105557"],"award-info":[{"award-number":["UG3\/UH3NS105557"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp; Dementia"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>As dementia cases increase and new therapies become available, timely diagnosis is critical yet challenging in primary care. We evaluated the TabCAT\u2010Brain Health Assessment (TabCAT\u2010BHA) digital paradigm to assist with early detection and diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This implementation study involved 21 primary care providers (PCPs) serving 2733 eligible patients in a family medicine clinic. PCPs initiated cognitive screening using the TabCAT\u2010BHA, administered by medical assistants, with results integrated into the electronic health record. The study assessed changes in PCP cognitive diagnoses, specialist referrals, and implementation metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      TabCAT\u2010BHA was adopted by 95% of PCPs, who were more likely to diagnose cognitive disorders (adjusted odds ratio: 1.72, 95% confidence interval: 1.13\u20132.62,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01). Practice\u2010wide diagnosis rates remained elevated after research support ended. PCPs reported increased confidence, reduced stress in diagnosing dementia, and preferred TabCAT\u2010BHA over traditional assessments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>TabCAT\u2010BHA was well accepted and sustained, offering a scalable solution for cognitive impairment diagnosis in primary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>A digital test paradigm increased cognitive impairment diagnoses in primary care.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Increased diagnoses across minority groups may mitigate healthcare disparities.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Clinicians preferred the digital cognitive assessment over alternative tests.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The paradigm decreased clinician stress and increased confidence around diagnosis.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Integration with clinic staff workflow yielded high adoption and sustainability.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70437","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T05:00:26Z","timestamp":1751605226000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Enhancing early detection of cognitive impairment in primary care with the TabCAT\u2010BHA"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3955-5428","authenticated-orcid":false,"given":"Andrew G.","family":"Breithaupt","sequence":"first","affiliation":[{"name":"Memory and Aging Center, Department of Neurology University of California  San Francisco California USA"},{"name":"Goizueta Institute at Emory Brain Health, Department of Neurology Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alissa Bernstein","family":"Sideman","sequence":"additional","affiliation":[{"name":"Philip R. Lee Institute for Health Policy Studies University of California  San Francisco California USA"},{"name":"Department of Humanities &amp; Social Sciences University of California  San Francisco California USA"},{"name":"Global Brain Health Institute University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collette","family":"Goode","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Hill\u2010Sakurai","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, School of Medicine University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukund","family":"Premkumar","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, School of Medicine University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron W.","family":"Scheffler","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Biostatistics University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Chodos","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Tsoy","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology University of California  San Francisco California USA"},{"name":"Global Brain Health Institute University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine P.","family":"Rankin","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel H.","family":"Kramer","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nhat","family":"Bui","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Jarrott","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Gaynor","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odmara L. Barreto","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Care University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Chow","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James G.","family":"Kahn","sequence":"additional","affiliation":[{"name":"Philip R. Lee Institute for Health Policy Studies University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine L.","family":"Possin","sequence":"additional","affiliation":[{"name":"Memory and Aging Center, Department of Neurology University of California  San Francisco California USA"},{"name":"Global Brain Health Institute University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30499-X"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31828726f5"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0b013e3181a6bebc"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001096"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2018.09.009"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.4782"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31363-6"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216313493685"},{"key":"e_1_2_8_10_1","unstructured":"Guiding an Improved Dementia Experience (GUIDE) Model| CMS [Internet]. [cited April 18 2024].https:\/\/www.cms.gov\/priorities\/innovation\/innovation\u2010models\/guide"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.4764"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.17226\/26026"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2212948"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.13239"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2020.19"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jnc.13640"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-014-0192-4"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2004.52054.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1964"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8227(00)00195-9"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0317-y"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4603-2"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05013-7"},{"key":"e_1_2_8_24_1","unstructured":"TabCAT | Detect cognitive changes earlier. [Internet]. TabCAT Health. [cited October 11 2024].https:\/\/tabcathealth.com"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-215106"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15208"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/dad2.12042"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-200985"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-021-00776-w"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13686"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.3329"},{"key":"e_1_2_8_32_1","unstructured":"Primary Care Portal [Internet].Memory and Aging Center. [cited 2023 Dec 22].https:\/\/memory.ucsf.edu\/services\/gateway\/primary\u2010care\u2010portal"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18258"},{"key":"e_1_2_8_34_1","unstructured":"Clinical Classifications Software Refined (CCSR) for ICD\u201010\u2010CM Diagnoses [Internet]. [cited May 7 2021].https:\/\/www.hcup\u2010us.ahrq.gov\/toolssoftware\/ccsr\/dxccsr.jsp"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.2307\/1403572"},{"key":"e_1_2_8_36_1","volume-title":"Generalized Estimating Equations","author":"Ziegler A"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2019.00064"},{"key":"e_1_2_8_38_1","unstructured":"Assessing Maintenance \u2013 RE\u2010AIM [Internet]. [cited July 3 2024].https:\/\/re\u2010aim.org\/assessing\u2010maintenance\/"},{"key":"e_1_2_8_39_1","unstructured":"R Core Team(2023)._R: A Language and Environment for Statistical Computing_. R Foundation for Statistical Computing Vienna Austria.https:\/\/www.R\u2010project.org\/"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01"},{"key":"e_1_2_8_41_1","first-page":"1","article-title":"The R Package geepack for generalized estimating equations","volume":"15","author":"H\u00f8jsgaard S","year":"2006","journal-title":"J Stat Softw"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8317.1990.tb00939.x"},{"issue":"1","key":"e_1_2_8_43_1","article-title":"State of science: bridging the science\u2010practice gap in aging, dementia and mental health","volume":"66","author":"Callahan CM","year":"2018","journal-title":"J Am Geriatr Soc [Internet]"},{"key":"e_1_2_8_44_1","volume-title":"Implementing High\u2010Quality Primary Care: Rebuilding the Foundation of Health Care [Internet]","author":"National Academies of Sciences E, Division H and M, Services B on HC, Care C on IHQP","year":"2021"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X713837"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.2196\/11072"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16247"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4606-4"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03012-8"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0435"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-024-02544-9"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.40411"}],"container-title":["Alzheimer's &amp; Dementia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alz.70437","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/alz.70437","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alz.70437","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:59:18Z","timestamp":1784303958000},"score":1,"resource":{"primary":{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/10.1002\/alz.70437"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":51,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/alz.70437"],"URL":"https:\/\/doi.org\/10.1002\/alz.70437","archive":["Portico"],"relation":{},"ISSN":["1552-5260","1552-5279"],"issn-type":[{"value":"1552-5260","type":"print"},{"value":"1552-5279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2024-10-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70437"}}