What question did this study set out to answer?

To evaluate the effect of a brief culturally adapted dementia screening tool integrated into the EHR on diagnosis and management in primary care.

April 17, 2026

Increased dementia diagnosis and workup in primary care with a bilingual screening tool integrated in the electronic health record

Key Points

To evaluate the effect of a brief culturally adapted dementia screening tool integrated into the EHR on diagnosis and management in primary care.
Developed and integrated a bilingual dementia screening tool into the EHR.
Patients aged 60 and older completed the screening before annual wellness visits.
Conducted a pre-post study comparing patient data from before and after the implementation of the tool.
New dementia diagnoses rose from 0.75% pre-DST to 2.45% post-DST among those screening positive.
Adjusted odds ratio for new diagnoses was 2.99, indicating a significant increase.
Post-intervention, there were notable increases in dementia medications, lab orders, and specialty referrals.

Abstract

BackgroundAlzheimer's disease (AD) affects over 10% of adults aged 65 and older. Black and Hispanic/Latino individuals experience 1.5-2.0 times higher prevalence than White individuals, yet AD remains underdiagnosed, particularly in non-White populations. Common screening tools such as the Mini-Mental State Examination and Montreal Cognitive Assessment are limited by time burden and cultural sensitivity.ObjectiveTo evaluate the impact of integrating a brief dementia screening tool (DST) into the electronic health record (EHR) on diagnosis, evaluation, and treatment in primary care.MethodsThe DST, developed by the University of California Alzheimer's Disease Centers and the California Department of Public Health, takes under five minutes and includes a three-question patient form, optional informant questionnaire, and Mini-Cog. It was translated and culturally adapted for Spanish-speaking patients and embedded in the EHR. Patients aged ≥60 in a diverse Los Angeles County family medicine clinic completed the DST before annual wellness visits. We conducted a pre-post study comparing patients without prior dementia diagnoses during pre-intervention (February 2021-August 2022) and post-intervention (January 2023-June 2024) periods. Primary outcome was new dementia diagnosis; secondary outcomes included medications, referrals, labs, and imaging.ResultsAmong 1515 eligible patients post-intervention, 1249 completed screening. New dementia diagnoses increased from 0.75% pre-DST to 2.45% among those screening positive (adjusted OR 2.99; p = 0.01). Dementia medications, laboratory orders, and specialty referrals significantly increased; imaging did not.ConclusionsA brief, culturally adapted DST integrated into primary care improved dementia diagnosis, evaluation, and treatment.

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Increased dementia diagnosis and workup in primary care with a bilingual screening tool integrated in the electronic health record

Key Points

Abstract

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