A new travel-themed app could help GPs kickstart difficult conversations with their patients about cognitive decline.
Picture this: you’re going travelling, and you’ve booked a tour. Maybe to Europe, or South America – the destination isn’t important.
What’s important is what happens when you meet your tour group.
You are introduced to four travel companions. You get a name, a face and a fact. You are then asked to immediately recall elements of the interaction.
You are then asked to watch a mindfulness video to take your mind off things. And after that, you need to once again relay information about the group.
It sounds simple, but this situation can reveal important information about cognitive processes.
Immediate and delayed recall, abstract thinking and facial recognition are things that may come naturally to some, but can be a struggle for those experiencing cognitive decline.
And for those who struggle, it may be a warning sign of oncoming dementia.
This activity, called “Meet and Greet”, is one of the eight travel games used in the dementia screening app BrainTrack. Released this month by Dementia Australia, BrainTrack is a free tool that patients can use to monitor their cognition over time.
Almost half a million Australians live with dementia, a number which is projected to increase to over a million by 2058. And according to Dementia Australia CEO Maree McCabe, catching symptoms early can significantly improve the chances of diagnosis and management.
“Users are prompted to log in monthly to play the games, and within the app can easily generate a pdf report of the results that can be emailed to their GP,” Ms McCabe said.
“While not intended to replace a formal cognitive assessment, BrainTrack supports the early identification of cognitive changes over time that may warrant further testing.”
According to Austin Health aged care research, memory clinic and wound clinic director, Associate Professor Michael Woodward, there are still low detection rates of dementia in primary care.
He said there are four reasons for this. The first is a “nihilism” surrounding aging, a “nothing we can do about it” attitude.
Secondly, a lack of knowledge around testing. Thirdly, it can be difficult to assess whether decline can be attributed to an odd episode or to something more significant. And lastly, it is not easy for GPs to get longitudinal data of how a person’s memory is tracking over time.
“What this app does is try to give you that [longitudinal data]. So, even if they’re still within the so-called normal range, if they’re falling off, if their cognition is becoming worse over a period of months or even years, that’s very suggestive that there’s something significant going on,” Associate Professor Woodward told Wild Health.
“The person who is concerned by their performance on the app will hopefully then go and discuss it with a health professional,” he said.
BrainTrack prompts users to fill in a health check when they start the app. It then gives recommendations for a few things they should pay attention to, such as heart health, weight, diet, sleep, and keeping socially active.
Associate Professor Woodward is a Dementia Australia honorary medical advisor. He told Wild Health that the app would hopefully support GPs to have difficult conversations with their patients experiencing cognitive decline.
“Don’t just dismiss it that automatically say, ‘well, that’s normal aging. We all start forgetting more as we get old, nothing can be done about it so why worry yourself’ … those sorts of approaches are to be avoided.
“But, if a person expresses problems with their cognition, or indeed if the GP picks it up – if the person is repeatedly forgetting their scripts, missing appointments, or not turning up for investigations, these are warning signs and the GP should have a chat,” he said.
The GP could then work in tandem with the patient to monitor their cognition, using the app as a starting point.
