Dementia & Cognitive Triage Navigator

Why Primary Care Dementia & Cognitive Triage Navigator?

Engineered for the 15-Minute Visit

Structured around a practical clinical visit pacer that paces intake, rapid screening, reversible etiology workup, and documentation without derailing primary care clinic schedules.

Accurate Staging & Deficit Identification

Couples the validated Mini-Cog (word recall and clock draw) with an unambiguous functional deficit assessment (ADLs/IADLs) to clearly separate Mild Cognitive Impairment (MCI) from Major Neurocognitive Disorder.

Automated Triage & EHR Generation

Screens for depressive pseudodementia via PHQ-2, flags red-flag specialist referral criteria, cross-checks Beers criteria medications, and compiles complete, structured EHR documentation in one click.

Clinical Workflow: 4-Stage Triage Architecture

Module 1: Cognitive Screening & Functional Deficit Review

  • Demographics & Trajectory: Capture age, primary complaint source, collateral history, and onset velocity (gradual vs. rapid).
  • Standardized Mini-Cog: Guided 3-word registration, clock drawing test (11:10), and delayed unprompted recall scoring.
  • Depressive Pseudodementia Screen: Gateway PHQ-2 assessment to rule out affective cognitive mimics prior to permanent neurocognitive staging.
  • Deficit-Focused ADL/IADL Tracking: Clear identification of established functional losses (medications, finances, driving, personal care) with instant “Mark All Independent” reset options.

Module 2: Reversible Etiology & Rule-Out Protocol

  • Laboratory Workup: Targeted primary care panels to exclude reversible causes, including TSH, Vitamin B12, CMP, CBC, and indicated secondary studies.
  • Structural Neuroimaging Selection: Guidance on choosing non-contrast head CT versus brain MRI based on acute focal deficits, onset speed, and clinical context.
  • Pseudodementia Cross-Reference: Active alert flags when elevated depressive symptoms suggest cognitive deficits may be mood-mediated.

Module 3: Safety Hard-Stops & Beers Medication Audit

  • Key Safety Screens: High-liability home safety checks including driving safety, medication administration errors, wandering/firearm risk, and power of attorney (POA) planning.
  • Beers Criteria Deprescribing: Rapid identification of high-risk cognitive offenders (anticholinergics, sedating antihistamines, benzodiazepines, sedative-hypnotics).
  • Specialist Referral Thresholds: Dynamic detection of red flags requiring neurology, geriatrics, or neuropsychology consultation (rapid progression, motor signs, early onset <65 years).

Module 4: EHR Dotphrase & Patient Action Plan

  • Structured EHR Output: Generates a clean .dementiaeval clinical note synthesizing history, objective scores, diagnostic impression, and billing-ready documentation.
  • Printable Caregiver Summary: Plain-language patient and family care plan outlining initial lab/imaging orders, home safety recommendations, and follow-up timelines.

How to Use the Dementia & Cognitive Triage Navigator in Practice

  1. Load Case Baseline or Preset: Enter patient age, symptom onset, and collateral observations, or select an archetypal case preset (Amnestic, Rapid Red Flag, or Polypharmacy) from the header dropdown.
  2. Administer Objective Screens (0–4 min): Administer the 3-word registration, prompt the clock drawing test, assess delayed recall, and score the 2-item PHQ-2 mood screener.
  3. Screen Functional Deficits (5–8 min): Check off active impairments across Instrumental and Basic ADLs to establish whether daily independence is preserved (MCI) or compromised (Dementia).
  4. Audit Reversible Factors & Safety (9–14 min): Order baseline rule-out labs/imaging, review the patient’s medication list for Beers criteria anticholinergics, and address critical driving and home safety hard-stops.
  5. Export & Document (15 min): Monitor the Right-Rail HUD for specialist referral triggers, copy the pre-formatted clinical note directly into your EHR, and print the caregiver guidance handout.

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