Northwestern University

MyCog: Rapid detection of cognitive impairment in everyday clinical settings

Cognitive impairment (CI) and dementia are significant public health burdens that can have profound social and emotional effects on older adults. Early detection of CI is imperative in order to identify potentially treatable underlying causal conditions, and in cases where cure is not possible, to provide supportive services to minimize the effects of CI. While primary care and other clinical settings are ideal places for identifying CI, it frequently goes undetected. The availability of screening tools for use in these settings is currently limited, and existing options are often unsuitable for implementation in such settings because of their length, cost, or need for specialized equipment or highly trained administrators. The MyCog project will address this clinical need by developing a brief and standardized set of CI screening measures that is suited for use in diverse settings and with diverse populations.

The MyCog screener will be comprised of two cognitive measures drawn from the NIH Toolbox for Assessment of Neurological and Behavioral Function® and the Everyday Cognition self- and informant-report measures. Available as a downloadable app, MyCog will be validated in a large and diverse sample of adults (ages 65+) who are enrolled in the LitCog Study of Health Literacy and Cognitive Function among Older Adults. In addition to this validation among populations with varying levels of health disparities, it will be an important component of the MyCog project to optimize the screener for use in primary care settings.

Investigators

Richard Gershon, Principal Investigator, Steering Committee

Michael Wolf, Principal Investigator, Steering Committee, Data Harmonization Committee

David Condon, Steering Committee, Analysis Committee

Marina Arvanitis, Clinical Practice Committee

Laura Curtis, Analysis Committee

Julia Yoshino Benavente, Steering Committee, Clinical Practice Committee

Rachel O’Conor, Data Harmonization Committee

Zahra Hosseinian, project manager, steering committee

richard gershon, PhD

Vice Chair of Research and Professor of Medical Social Sciences

Northwestern University, Feinberg School of Medicine

In response to the realization that the outcomes tools which he was using in clinical practice were outdates and failed to cover the needs of his patients, Dr. Gershon’s career has increasingly focused on the development of modern assessment tools. He is continuously striving to find new ways to assess outcomes of treatment and methodologies and to get that information into the hands of clinicians in a manner that can immediately impact treatment. Over the years and with requests from the NIH, his team optimized existing and developed dozens of new Patient Reported Outcome Measures. In his role as Principal Investigator for the NIH Roadmap Patient Reported Outcomes Measurement Information System (PROMIS) Technical Center, Dr. Gershon has served as technology host for more than 2,000 researchers and clinicians who are registered users of AssessmentCenter.net – a test authoring and study administration portal which he created as part of PROMIS I and which now serves as the host for the web-based versions of many instrument systems. As PI for the NIH Toolbox for the Assessment of Neurological and Behavioral Function, he oversaw a team of 235 researchers from around the world to create a large battery of instruments for clinical-investigators to assess various areas within cognitive, motor, sensory and emotional health, for longitudinal, clinical and comparative effectiveness research. In addition to his work for MyCog (Northwestern’s Detect-CID project), Dr. Gershon serves as MPI for the NIA sponsored grant Advancing Reliable Measurement in Alzheimer’s populations and older age groups, as well as for the Environmental influences on Child Health Outcomes (ECHO) PRO Measurement Core where his group recommends, develops and curates assessment delivery for over 80 sites. He also serves as PI on the recently awarded NIH Infant and Toddler Toolbox (aka Baby Toolbox) contract to develop a cognitive assessment battery for infants and children aged 1-42 months. This background is further augmented by his role as a co-investigator and/or consultant on over 100 assessment development projects in health care, education, and certification.

michael wolf, ma, mph, phd

Professor of Medicine

Northwestern University, Feinberg School of Medicine

Dr. Michael Wolf is a health services researcher and cognitive/behavioral scientist with expertise in aging, chronic disease self-management, health literacy and the design of health system interventions to promote health, particularly among more medically complex, older adults living with multiple chronic conditions (MCC). For the past two decades, Dr. Wolf has led studies investigating: 1) individual and health system determinants of health services use and outcomes, and 2) the effectiveness and fidelity of interventions aimed at helping patients better engage in healthcare and self-manage chronic conditions. Since 2007, Dr. Wolf has served as PI of a large, NIA-funded cohort study (LitCog) that examines associations between community dwelling, primary care patients’ self-management skills, functional status (cognitive, physical, mental), healthcare utilization and clinical outcomes over time. In addition, he leads several multi-site NIH clinical trials testing primary care-based interventions to improve self-management and clinical outcomes among older patients with one or more chronic conditions. All of these interventions leverage existing and highly scalable health and consumer technology tools to link patients to their primary care team between visits. In 2004, Dr. Wolf founded the Health Literacy & Learning Program (HeLP) to create a network of multidisciplinary faculty that could partner together to generate applied, innovative research that would help transform the delivery of healthcare for vulnerable patients (older adults a specific target). In 2019, he was named Founding Director of the Feinberg School of Medicine’s Center for Applied Health Research on Aging (CAHRA), which seeks to promote informed decision-making and actions leading to optimal health and well-being among individuals and families over the life span. He also holds administrative roles since 2009 as Associate Division Chief (GIMG) and Associate Vice Chair (Medicine). With a mandate to catalyze health services research across GIMG and all clinical divisions.

Marina Arvanitis, MD, MPH

Marina Arvanitis, MD, MPH is a primary care internist and pediatrician, and a health services researcher focusing on health literacy, patient-reported outcomes, and health care quality. She is particularly interested in understanding the life course development of health literacy, including the role that cognition plays in this development, as well as the effects of health literacy on individual and family health, and how it can be promoted within families. Dr. Arvanitis completed a combined Internal Medicine and Pediatrics residency at the Medical College of Wisconsin, and a National Research Service Award Primary Care Research Fellowship at the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill. She is now an assistant professor at Northwestern University, where she is a researcher in the Health Literacy and Learning Program (HeLP), and provides primary care for adults and children at Northwestern Medical Group and the Lurie Children’s Hospital of Chicago.

Laura Curtis, MS

Laura Curtis, MS is a Research Assistant Professor in the Division of General Internal Medicine and Geriatrics at Northwestern University. She has worked as research scientist and statistical analyst with the Health Literacy and Learning Program (HeLP) for over 10 years.  Her research focuses on examining the measurement of health literacy and cognition and their roles in patients’ ability to self-manage their health and improve functional health outcomes.  Ms. Curtis has her Master’s degree in biostatistics and currently directs HeLP’s Data Analysis Unit where she supervises data analysts and programmers.

Julia Yoshino Benavente, MPH

Julia Yoshino Benavente, MPH is a Research Project Manager in the Division of General Internal Medicine and Geriatrics at Northwestern University. She received her MPH in Epidemiology and Maternal and Child Health from the University of Washington and has over ten years of research coordination and research project management experience in the fields of early phase oncology, pediatric infectious diseases, and health services research. Ms. Yoshino Benavente has been working with Dr. Michael Wolf and his team in the Health Literacy and Learning Program (HeLP) at Northwestern for the past four years and manages the program’s cognitive aging research portfolio.

Rachel O'Conor, PhD, MPH

Rachel O’Conor, MPH is a Clinical Research Associate within the Division of General Internal Medicine and Geriatrics at the Northwestern University Feinberg School of Medicine, and doctoral candidate in Public Health.  Her research focuses on psychosocial and cognitive determinants of chronic disease self-management behaviors and health outcomes among older adults, and is interested in the design of health system interventions to promote self-management behaviors and health outcomes among individuals with chronic illness, particularly for adults who experience significant social and economic hardship and shoulder an unequal burden of many conditions.   She has worked with the Health Literacy and Learning Program for the past 9 years and directs the program’s chronic disease self-management research portfolio.