Taking steps to ensure cognitive tests work for everyone

Lead Investigator: Dr Emma Elliott  

Institution: University of Manchester

Grant type: Career Development

Start date: April 2026

Duration: 12 months

Amount: £68,059

Summary sentence:

Dr Elliott will conduct a review of GPs’ knowledge of cognitive tests used to diagnose dementia with the long-term aim of improving diagnosis for the wider population through a larger programme of work to improve cognitive screening in primary care.

Short description (100 words):

Cognitive tests are used as part of a dementia diagnosis to assess things like attention and memory. However, these tests were not designed to take into account individual differences, such as the amount of education someone has had or cultural background. In addition, they are less sensitive to the early stages of cognitive decline when changes may be more subtle. These issues can result in delays in getting a diagnosis from a GP.

Dr Elliott will review GPs’ knowledge of cognitive tests and attitudes to dementia diagnosis. She will also identify cognitive tests produced or adapted for underserved populations. Her work will inform a larger programme of work she is carrying out to improve cognitive testing for people with suspected dementia visiting primary care.

Long description (250 words):

Cognitive tests are commonly used by GPs to support a diagnosis of dementia. These tests assess thinking abilities, such as memory and attention. However, these tests do not factor in the different needs and backgrounds of individuals. The tests do not account for educational background, were not developed for ethnic minority groups, and are less sensitive to early stages of cognitive decline when changes may be subtle. Because of the way the tests are designed, people with low education levels and from ethnic minority communities can score low and people with higher education levels and at early stages of dementia can score full marks. This can mean people get a diagnosis much later or even receive an incorrect diagnosis.

Dr Elliott believes GPs would benefit from training and guidance in cognitive screening so will assess both GPs' knowledge of cognitive screening and their views on screening and diagnosing dementia. She will also conduct a review to identify cognitive tests designed or adapted for people from underserved communities. She will consult with people living with dementia, care partners and GPs on how to improve cognitive screening in primary care.

Her findings will inform a larger programme of work which seeks to improve cognitive screening in primary care that she is leading. Once her project is completed, she plans to design a fuller follow-on project and apply for a fellowship to carry on her research. Dr Elliott hopes her work will contribute to putting an end to inequalities in diagnosis.