Detecting preclinical Cognitive Impairment in the Digital Era
Current approaches to study cognitive aging and dementia take a largely silo approach that leads to incremental progress tied to pre-existing presumptions. Accepting the reality that what we know may be far less than what we don't know, and that true paradigmatic shifts in science often are galvanized by those coming from outside the inner academic circles, it is important to look beyond the traditional and embrace new approaches. Digital technology and big data is fueling unprecedented new directions in the commercial community. President Obama’s Precision Medicine Initiative and NIH’s interest in a million-person mega study is also creating a ground shift in what might be a more effective means for conducting medical research. Within this context, how we study outcomes of cognitive aging, including those associated with the earliest stages of Alzheimer’s disease (AD) and other progressive dementias needs to be considered. Digital technologies and global multi-sector partnerships can lead to forward thinking research methods from which to develop more effective strategies for promoting cognitive health, AD disease prevention and early detection capabilities of previously believed asymptomatic stages to facilitate effective intervention strategies. The Framingham Cognitive Aging Study provides a case example of cognitive assessment methods that incorporate digital capture of performance. By leveraging the Framingham experience, we have created a transformative platform designed to catalyze groundbreaking discoveries for cognitive impairment prevention, inform policies for reducing the economic cost and healthcare burden generally associated with progressive dementing disorders, such as Alzheimer’ disease, and identify determinants of sustained lifelong cognitive health. Cognitive decline with age does not have to be inevitable and through adoption of e-digital health technologies there is opportunity to dramatically change our understanding of how the brain ages.