{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T10:59:58Z","timestamp":1785581998554,"version":"3.56.0"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":75,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG069765"],"award-info":[{"award-number":["R01AG069765"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alz &amp;amp; Dem Diag Ass &amp;amp; Dis Mo"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>Unrecognized cognitive impairment remains common in primary care, delaying access to care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a prospective cross\u2010sectional study to evaluate a multimodal screening approach combining a passive digital marker (PDM) from electronic health records with the Quick Dementia Rating System (QDRS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Individually, each method showed limited discrimination (area under the curve [AUC] 0.61\u20130.62). The combined model, incorporating PDM, QDRS, and comorbidity context, improved performance (AUC 0.79; sensitivity 0.75; specificity 0.71). Decision curve analysis showed a net benefit of 0.5 at a 50% risk threshold, corresponding to a modest increase in correctly identified cases relative to alternative screening strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>This low\u2010burden, scalable multimodal approach improves detection of cognitive impairment, including mild cognitive impairment and Alzheimer's disease and related dementias, and may support improved risk stratification and referral prioritization in primary care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dad2.70393","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T02:57:12Z","timestamp":1781578632000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing scalable approaches for early detection of cognitive impairment in primary care"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4580-7428","authenticated-orcid":false,"given":"Arthur H.","family":"Owora","sequence":"first","affiliation":[{"name":"Translational Informatics, Biostatistics and Epidemiology Lab Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Center for Biomedical Informatics Regenstrief Institute  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Summanwar","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambar","family":"Kulshreshtha","sequence":"additional","affiliation":[{"name":"Department of Family and Preventive Medicine Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zina Ben","family":"Miled","sequence":"additional","affiliation":[{"name":"Phillip M. Drayer Department of Electrical and Computer Engineering Lamar University  Beaumont Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R.","family":"Dexter","sequence":"additional","affiliation":[{"name":"Center for Biomedical Informatics Regenstrief Institute  Indianapolis Indiana USA"},{"name":"Department of Medicine Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bowen","family":"Jiang","sequence":"additional","affiliation":[{"name":"Translational Informatics, Biostatistics and Epidemiology Lab Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yash","family":"Shah","sequence":"additional","affiliation":[{"name":"Translational Informatics, Biostatistics and Epidemiology Lab Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Puster","sequence":"additional","affiliation":[{"name":"Department of Medicine Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Coppedge","sequence":"additional","affiliation":[{"name":"Indiana University Center for Aging Research  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanell","family":"Disla","sequence":"additional","affiliation":[{"name":"Comprehensive Center for Brain Health Department of Neurology University of Miami Miller School of Medicine  Boca Raton Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Galvin","sequence":"additional","affiliation":[{"name":"Comprehensive Center for Brain Health Department of Neurology University of Miami Miller School of Medicine  Boca Raton Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole R.","family":"Fowler","sequence":"additional","affiliation":[{"name":"Center for Biomedical Informatics Regenstrief Institute  Indianapolis Indiana USA"},{"name":"Department of Medicine Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Indiana University Center for Aging Research  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malaz","family":"Boustani","sequence":"additional","affiliation":[{"name":"Center for Biomedical Informatics Regenstrief Institute  Indianapolis Indiana USA"},{"name":"Department of Medicine Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Indiana University Center for Aging Research  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Alzheimer's Association.Alzheimer's disease facts and figures. 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