The aim of this research is to determine whether cognitive markers of dementia in older persons presenting to a primary care physician's office can be effectively detected using a computerized, Internet-based cognitive screening system. A neuropsychologist, in collaboration (over a 3 year period) with a team of over 20 software designers and engineers, developed the 15-25 minute test battery. Normative data has already been gathered on healthy older adults across a wide range of ethnic and socioeconomic backgrounds. As the population of the United States ages, it is believed that the number of citizens with dementing disorders will reach epidemic proportions. Early detection and treatment of Alzheimer's Disease is especially important now that several FDA-approved medications are available that may help stem the progression devastating symptoms. However, the nation is facing a shortage of geriatric physicians. Early detection will continue to rely heavily on primary care physicians who are constrained by the current model of primary care practice, along with the limitations of available cognitive assessment tools. The proposed study will require recruitment of 100 patients of a primary care clinic, ages 65 and older, as they present for routine medical visits. All patients who consent to participate and have the basic visual and motor capabilities necessary to interact with computerized interface, as well as the ability to follow simple instructions, will be included in the study. Cognitive testing will be conducted in a private office. A technician will be available for the duration of test sessions to monitor proper usage of the computer and ensure task comprehension. The clinical examination will be conducted by the Geriatric Evaluation Unit medical staff. Paper and pencil cognitive test results, along with clinical diagnoses, will be recorded in the patient's record. The technician will be responsible for retrieving these data from the medical records and entering them into an SPSS database.
