Context and Project Goal

Identification of early cognitive changes is essential for dementia prevention and enabling timely access to future disease-modifying treatments. However, the lack of a targeted, standardized cognitive screening system globally and in Germany remains a significant barrier to identifying Alzheimer’s disease in its early stages. Therefore, screening individuals with subjective cognitive decline (SCD) offers a critical opportunity for early intervention and improved outcomes. This project evaluated the feasibility, effectiveness, and efficiency of a pragmatic, community-based cognitive screening program for older adults. The initiative actively engaged participants through senior centers and social and cultural activities across the greater Munich area.

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Project Description

This project compared three variations of a cognitive screening approach within a three-stage diagnostic process. It combined SCD questionnaires with digital cognitive testing and blood sampling, followed by medical assessments by general practitioners and detailed examinations by dementia specialists at a university memory clinic. Participants were divided into three groups to compare the different screening methods.

In Group 1, participants answered a questionnaire about SCD. Group 2 completed the same questionnaire and a digital cognitive test. Group 3 completed both tasks and also provided a blood sample for Alzheimer’s biomarker testing. If any results indicated possible cognitive issues, participants were encouraged to visit their primary care doctor.

Primary care doctors received the test results along with guidance on how to interpret them, but they were free to decide what further steps to take. This could include routine medical tests, brain imaging, or referring patients to a specialist memory clinic. At the clinic, patients underwent in-depth diagnostic assessments, including detailed neurocognitive testing, brain MRI and determination of AD biomarkers in CSF and/or PET.