Brain Health Care Accelerator Model Redefines Dementia Diagnosis and Treatment in Primary Care
核心洞察
A new primary care-centered model called the Brain Health Care Accelerator shifts dementia (搜索) diagnosis and treatment from specialist neurologists to primary care providers, dramatically reducing time to diagnosis.
The national average time from symptom onset to dementia (搜索) diagnosis is 3.5 years, causing many patients to miss the treatment window for newly approved disease-modifying therapies.
The model has increased visits at The University of Kansas Health System (搜索)'s memory clinic by 60%, utilizing team-based care with nurse practitioners, physician assistants, and social workers.
A new primary care-centered approach to diagnosing and treating dementia (搜索), called the Brain Health Care Accelerator, is reshaping how patients access care at The University of Kansas Health System (搜索) — and its architects believe it offers a blueprint for addressing a growing national crisis in brain health.
The model, published this spring in Alzheimer's & Dementia (搜索), the journal of the Alzheimer's Association, places primary care at the forefront of dementia diagnosis and treatment, responding to a stark reality: the number of Americans aged 65 and older with Alzheimer's disease (搜索) is projected to reach 13.8 million by 2060, while the supply of neurologists trained in dementia remains critically limited, particularly in rural and underserved areas.
"It's a new day, a new era for brain health," said Jeffrey Burns, M.D., co-director of the University of Kansas Alzheimer's Disease Research Center (搜索). "We have these new tools — blood measures and the new drugs — (but) we're not using them well. No one is. So we have to rethink how we do it."
The Diagnostic Delay Problem
The current typical diagnostic pathway illustrates the urgency for change. Patients who report memory concerns to their primary care doctor often face a series of visits, eventual referrals to neurology, and months of waiting before a diagnosis is made. "The average time for diagnosis is three and a half years, nationally," said Burns. This delay means some individuals who could benefit from the first FDA-approved drugs that slow disease progression — rather than merely manage symptoms — miss the critical early-stage treatment window.
This finding is corroborated by a new report from the Gerontological Society of America (搜索) (GSA), "Understanding Breakthroughs in Brain Health: Top 10 Articles of 2025," which similarly found that the average time from symptom onset to a dementia (搜索) diagnosis is 3.5 years. The GSA report notes that only 8–11% of mild cognitive impairment (搜索) cases are identified early, with underdiagnosis disproportionately affecting Black and Hispanic populations.
How the Brain Health Care Accelerator Works
Under the new model, when a patient first reports memory concerns, the primary care doctor brings them back within one to two months for a comprehensive cognitive assessment. This visit incorporates cognitive screening tools, blood testing when indicated, and decision-support tools built directly into the electronic health record (EHR) that guide providers through an evidence-based workup. Providers can also request quick electronic consultations from the KU memory clinic.
"The new tools allow the primary care provider to confidently complete a cognitive assessment visit, which walks through all of the requirements to complete the evaluation, order appropriate tests, interpret those tests, diagnose the patient, start treatment and make appropriate referrals," said Jennifer Woodward, M.D., MPH, a primary care physician and associate professor of family medicine and community health at KU Medical Center.
The model also restructures the memory clinic into specialized subclinics: one for patients eligible for the new disease-modifying medications, another for those with atypical or complex cognitive syndromes, and a third for counseling and support. Burns said he envisions adding a subclinic focused on prevention and monitoring for people at elevated risk for Alzheimer's disease (搜索).
Team-Based Care and Early Results
Rather than relying solely on cognitive neurologists, the Brain Health Care Accelerator employs a team-based approach that leverages nurse practitioners, physician assistants, registered nurses, and social workers. These clinicians, once provided with training and structured protocols, can lead many aspects of treatment delivery and monitoring.
The early impact has been measurable: the new approach has increased the number of visits at KU's memory clinic by 60%. "We still have major growing pains, but we are serving far more (patients)," said Burns. "Because we've got all this change happening, we have to approach it with a whole new model of care, and we're trying to do that in a systemwide way."
Woodward added: "It's been incredible to see the difference it's made in the speed of diagnosis and getting patients to appropriate treatment so much more efficiently than the old refer-and-wait process. Patients are able to get everything completed with their trusted primary care provider and then move along the pathway more quickly."
The Broader Context: New Tools and Growing Burden
The GSA report underscores the critical and expanding role of primary care providers in early detection. "Primary care is where most people with dementia (搜索) are first diagnosed and where they receive most of their care," said Soo Borson, MD, co-lead of the BOLD Public Health Center of Excellence on Early Detection of Dementia and a professor at the Keck School of Medicine at the University of Southern California.
Alzheimer's disease (搜索) affects approximately 7.2 million Americans aged 65 and older, representing roughly 11% of that population. Health and long-term care costs for people living with AD and other dementias reached an estimated $384 billion in 2025, with an additional $413 billion in care provided by roughly 12 million unpaid caregivers.
Advances in diagnostic technology are helping to close the detection gap. Blood-based biomarker tests, now increasingly available to primary care providers, offer a less invasive and more accessible means of detecting Alzheimer's pathology compared with traditional PET imaging or cerebrospinal fluid analysis. Digital cognitive assessments are also emerging as practical tools for streamlining screenings, with the potential to integrate directly into electronic health records.
The GSA report also highlights the growing evidence linking modifiable lifestyle factors to brain health outcomes, including the landmark US POINTER randomized clinical trial, which demonstrated that structured, multidomain lifestyle interventions addressing exercise, diet, cognitive engagement, and social activity produced significantly greater cognitive benefits than self-guided approaches.
"Primary care providers are uniquely positioned to identify cognitive changes early and connect patients with the resources and interventions that can make a real difference," said Anna Pendrey, MD, DABOM, an assistant professor at the Indiana University School of Medicine. "Incorporating cognitive screenings into routine visits, and normalizing conversations about brain health, are practical, high-impact steps that every practice can take."