When most of us think about aging, occasionally forgetting names or misplacing keys gets brushed off as “just old age.” But these early signs can be more than harmless — they can be early indicators of Mild Cognitive Impairment (MCI) or even the early stages of dementia and Alzheimer’s disease. Too often, these changes go unnoticed, undiagnosed, or attributed to normal aging.
That’s where primary care providers (PCPs) — the doctors, nurse practitioners, and physician assistants many of us see regularly — step in as a critical first line of defense.
Why Primary Care Matters
Older adults visit their primary care doctor more frequently than any specialist. These trusted relationships mean PCPs:
- See patients routinely — often annually or more.
- Understand patients’ medical history and daily functioning.
- Are positioned to notice subtle declines over time.
This continuity makes primary care the ideal setting for early cognitive detection — long before concerns become urgent. In fact, studies show that PCPs are often the first clinicians to recognize cognitive impairment and make initial dementia diagnoses.
Yet despite this potential, cognitive impairment — especially MCI — is drastically underdiagnosed in primary care settings, with some research suggesting that only a fraction of expected cases are identified without systematic screening.
The Misconception: “Normal Aging” vs. Early Impairment
Putting memory concerns down to aging is natural — but it can delay critical conversations, support, and treatment opportunities. MCI is more than just occasional forgetfulness; it is often a transitional stage between healthy aging and dementia. Early recognition can:
- Help identify treatable causes
- Maintain independence longer
- Enable planning for future care and support
- Connect patients and families with community resources
Yet these benefits hinge on detection, not assumptions.
How PCPs Can Lead the Way: Practical Early Detection
Routine Cognitive Screening
One of the most effective ways PCPs can catch early impairment is through routine cognitive assessments integrated into standard visits — especially annual wellness visits.
Rather than waiting for patients or families to voice concerns, proactive screening ensures that changes aren’t missed simply because they weren’t obvious in conversation or behavior. Primary care settings see patients for a variety of reasons — not all related to cognition — and many subtle signs can be identified only through structured tools.
Digital Tools Make Screening Easier
Traditionally, cognitive testing could be time-consuming or hard to administer during a busy primary care visit. Modern tools like BrainCheck are changing that.
BrainCheck offers:
- Quick, clinically validated digital cognitive assessments that fit into regular visits, including Medicare Annual Wellness Visits.
- Integration into clinical workflows and EHRs, so results are actionable and traceable over time.
- Longitudinal tracking, which lets clinicians distinguish normal aging from meaningful cognitive change.
- A suite of cognitive screeners and care planning tools that help clinicians not just detect but monitor and manage cognitive health.
As BrainCheck’s mission states, making cognitive health a regular part of wellness visits can close the gap between the prevalence of impairment and its discovery — empowering PCPs to act earlier and more effectively.
Looking Forward: A New Standard of Care
Primary care sits at the crossroads of prevention, early detection, and ongoing care — and as the population ages, that role becomes even more vital.
Organizations like the Alzheimer’s Association emphasize improving the inclusion of cognitive assessments in health care quality measures and educating professionals on best practices for early diagnosis.
By embedding cognitive screening into primary care — supported by tools like BrainCheck — we can:
- Normalize brain health checks like we do blood pressure.
- Catch early changes that might otherwise go unnoticed.
- Give patients more time, more options, and more support.
Conclusion: Don’t Wait — Detect Early, Act Early
It’s time to move past the assumption that memory loss is simply a part of aging and empower primary care to lead a proactive approach to cognitive health. With thoughtful screening, digital tools, and an emphasis on early detection, PCPs can be the champions of brain health — giving patients and families the best possible outlook for the years ahead.
Reviewed by Bin Huang, PhD
Principal Scientist at BrainCheck
Bin Huang received his PhD in Computational Biology from Rice University in 2017, with training in mathematical modeling, statistical analysis, and machine learning applied to complex biological systems. At BrainCheck, he leads clinical studies and research focused on digital cognitive assessments, cognitive care planning, and AI-powered health technologies for patients with dementia and their care partners.
Frequently Asked Questions
1. Why are primary care providers important for early detection of cognitive impairment?
Primary care providers play a critical role in early detection of cognitive impairment because they see older adults more frequently than any other type of clinician. Regular visits allow primary care providers to observe subtle changes in memory, thinking, and behavior over time. Since early symptoms of Mild Cognitive Impairment (MCI) or dementia are often mistaken for normal aging, primary care providers are uniquely positioned to identify concerning changes early and initiate further evaluation or care planning.
2. Should cognitive screening be part of routine primary care visits?
Yes. Cognitive screening should be a routine part of primary care, especially during annual wellness visits for older adults. Early-stage cognitive impairment often goes undetected without formal screening. Using validated cognitive assessment tools helps primary care providers identify changes that may not be obvious during conversation alone, track cognitive health over time, and intervene earlier when treatment and support options are most effective.
3. How does BrainCheck support early detection of MCI and dementia in primary care?
BrainCheck provides a digital, clinically validated cognitive assessment platform designed for use in primary care settings. It enables quick and objective cognitive screening during routine visits, including Medicare Annual Wellness Visits. BrainCheck also supports longitudinal tracking, allowing providers to monitor changes in cognition over time and distinguish normal aging from potential impairment, helping facilitate earlier diagnosis and better patient outcomes. BrainCheck Assess is not intended to be used as a stand-alone diagnostic device.
