PCPs predict dementia progress via P300

If healthcare truly has a mind for dementia delay, it may be time to check in on the brain, a new PLoS ONE published study posits.

The neuro-research clan behind the report claims there’s a novel, more cost-effective option known as P300 — to be employed by primary care practices — that could work in offsetting the onset of dementia. The P300, also referred to as the brain health check-up, can essentially tally and document the likelihood of dementia in patients 20 years prior to its aggressive coup in as little as 15 minutes, a measure that could prove useful in protecting productivity in for Baby Boomers and beyond. 

"Diagnosis and treatment of MCI [mild/moderate cognative impairment] in a primary care setting may prevent and delay or potentially end the development of dementia," said Eric R. Braverman, MD, lead author lead author and former research partner of the New York State Commissioner of Health Nirav Shah.

According to a release and researchers, P300 operates as follows:

“A majority of individuals have an average brain speed of 300 milliseconds (msec) + their age (i.e., a 40-year-old has a brain speed of 340 msec) or P300, the test that measures brain age and waves. Individuals with brain speeds slower than 340 msec show progressive signs of cognitive decline and low brain metabolism on PET scan (Positron Emission Tomography). A healthy brain is at its peak performance processing information at 300-320 msec. Loss of even 4/100 of a second or brain speed slower than 340 msec correlates to lowered brain performance and cognitive decline. Most people lose 7-10 msec of brain processing speed per decade after age 40. For example, untreated patients from ages 80 to 100 have a brain speed of 380-400 msec, leaving them with some type of advanced dementia or MCI. The loss of brain processing speed is the best marker of memory and attention decline and the P300 is as easy to perform as an EKG or cholesterol blood test.”

Alongside emphasizing and chronicling P300 (slow brain speed) and performing the Test of Variables of Attention (TOVA), physician offices can look to MRIs and MRAs for additional support to stable a prognosis.

"Additional tests such as Magnetic Resonance Imaging and Angiogram (MRI/MRA) and others can provide further support for this new in-office model," said Mark Gold, MD, chairman of the Department of Psychiatry at the University of Florida in a prepared statement.

With all these elements in place, as early as age 40, the study argues that primary care providers can diagnose cognitive decline more effectively and fully.

“Brain health checkups in primary care will ultimately help diagnose cognitive decline long before symptoms become clinically evident, thus at an earlier stage of disease,” the study concluded. “The earlier cognitive decline is identified, the earlier treatments can be initiated to slow progression of disease and pave the way for millions to reverse the early stages of dementia with hormones, pharmaceuticals, nutrition and lifestyle changes. Authors of the study believe that no medical office in the United States is properly equipped without brain health checkups. These tools will provide early intervention steps that will ultimately have a positive impact on chronic brain-related diseases (i.e, obesity, depression, anxiety, insomnia, violence, addiction, etc.) afflicting millions.  According to the Alzheimer's Association, dementia including Alzheimer's disease has cost the United States $200 billion annually and parallels obesity and smoking as one of our most expensive health care problems. Menopausal women are increasingly affected by mild/moderate cognitive impairment, which includes both memory and attention losses. Partial dementia once identified and reversed through treatment, between ages 40 to 70, will increase the years of effective work, thus reducing the financial burden on Medicare.”