Transforming cognitive assessments. Strengthening Alzheimer's care.
Cogstate created a digital cognitive assessment that revolutionized the early detection of mild cognitive impairment in clinical research. By 2021, the time had come to go beyond clinical trials.
New treatments to slow the progression of Alzheimer's disease were emerging, but their efficacy depends on early detection. Yet 90% of people with mild cognitive impairment (an early indication of Alzheimer’s disease) go undiagnosed. To close this gap, Cogstate partnered with Public Works to reimagine Cognigram—a HIPAA-compliant, FDA Class II-exempt digital cognitive assessment proven effective in more than 2,000 clinical trials. Our goal was to transform the customer experience (CX) for Cognigram’s adoption in doctors’ offices and homes across the U.S.
Approach
Understanding the barriers to earlier detection
To begin, we immersed ourselves in the ecosystem—shadowing older adults, interviewing physicians, and meeting with Cogstate’s scientists, designers, and commercial stakeholders to better understand the behavioral, emotional, and operational conditions shaping cognitive assessments.
What we heard reframed the entire challenge: Many PCPs avoided conversations about cognitive impairment because they did not feel equipped to interpret results or navigate emotionally sensitive discussions with patients. Many older adults didn't perceive Cognigram as a cognitive assessment. To them, it’s a measure of their self-worth. And upon introduction, many fear the worst—cognitive impairment.
The implications were significant. If early detection was going to scale alongside emerging Alzheimer's disease-modifying therapies, the ecosystem needed more than a clinically valid cognitive assessment. It needed communication and operational infrastructure to increase clarity, build confidence, and sustain engagement over time.
The challenge was no longer simply product adoption. The challenge was designing the behavioral, emotional, and operational conditions required for implementation at scale.
Outcomes
Translating insight into ecosystem strategy
We translated the research into a human-centered strategy to integrate Cognigram into Medicare Annual Wellness Visits (MAWVs) and strengthen readiness for early detection of mild cognitive impairment and Alzheimer’s intervention across the care continuum. The strategy focused on four interconnected areas:
Product Value Reframe Cognigram as a tool for understanding and talking about brain health, rather than a test that signals impairment. Elevate its preventive value, normalize cognitive monitoring, and integrate emotional support throughout.
Clinical Integration Embed Cognigram seamlessly before and between MAWVs, integrate it into practice workflows, and provide supportive scripts, cues, and prompts to help primary care physicians initiate conversations confidently.
Data Communication Humanize results so primary care physicians and older adults feel equipped to interpret, contextualize, and discuss cognitive function across the spectrum of brain health—not just at the point of impairment.
Digital Optimization Reduce cognitive load, simplify the interface, replace negative feedback with positive reinforcement, and streamline the entire cognitive assessment experience for use in clinics and homes.
Together, these efforts generated 38 strategic design guidelines and a roadmap for commercialization, clinical integration, and long-term ecosystem adoption.
Impact
Accelerating Alzheimer's care
This work established the behavioral, emotional, and operational foundations needed for earlier Alzheimer’s detection to scale alongside emerging therapies. More specifically, the initiative:
Validated health system readiness for earlier cognitive assessment
Identified pathways for clinical integration across care settings
Strengthened commercialization strategy for broader adoption
Increased confidence among PCPs initiating conversations about cognition
Reframed cognitive assessment around brain health and prevention
Aligned scientific, clinical, product, and commercial teams around a shared vision for earlier intervention
As Cogstate CEO Brad O’Connor shared: “The impact goes beyond product innovation and adoption. It paves the way for early detection—detection that, because of new therapies, could prolong the quality of life for millions of Americans.”
Today, the work continues to inform how cognitive assessment, communication, and early intervention strategies evolve alongside the next generation of Alzheimer’s therapies.
Because the future of Alzheimer’s care will not be shaped by science alone. It will be shaped by the systems, experiences, and relationships that empower people to detect cognitive change earlier, intervene sooner, and navigate brain health with greater clarity and confidence.