According to a 2020 report released by the Alzheimer’s Association, there are more than five million Americans living with Alzheimers—a number that is expected to triple by 2050. In the same report, nearly 87% of primary care physicians (PCPs) fully expect to see that increase but half reported that the PCP field is not prepared to meet the increased need.
Because of a shortage of dementia care specialists, ensuring that PCPs are prepared to provide dementia care is critical, but can be difficult when nearly 40% of PCPs report they are “never” or only “sometimes” comfortable making a diagnosis of Alzheimer’s or other dementias. While one-third of PCPs say they refer dementia patients to specialists at least once a month, more than half say there aren’t enough specialists in their area to meet demand, especially in rural areas.
This gap in dementia care makes it harder for PCPs to diagnose and treat patients effectively. That’s why Durham-based startup Mindr is working to make cognitive health data more prevalent and easier to understand for not only healthcare providers, but also for patients.
Mindr is a wellness digital platform designed to help users screen for any sort of cognitive decline. Using evidence-based reports developed by cognitive medical professionals, their app keeps track of personalized prevention plans and daily activities dedicated to delaying the onset of any cognitive disease, if in fact the user is at risk.
While beginning her career in digital health, Mindr’s Founder and Chief Scientific Officer (CSO) Inna Marquard realized that while dementia—or any debilitating cognitive decline—is increasingly widespread, many people aren’t open to talking about it. That leads to significant gaps in understanding when, why and how cognitive decline starts.
From findings of the medical journal The Lancet Commission, 40% of dementia cases are due to 12 modifiable risk factors, which include smoking, air pollution and more. According to Marquard and Mindr’s CEO Adam Schultz, this percentage of cases can be reduced using specified, sustainable activities and approaches for dementia prevention and risk reduction.
“There are many emotions and fears around the topic of dementia or Alzheimer’s,” Marquard said. “That’s why our first mission is to raise awareness of the easy, at-home ways to reduce the risk of cognitive decline.”
Mindr’s platform is based and designed around the FINGER Study (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability), which demonstrated that a multidomain intervention plan based on five daily activities can improve and/or maintain cognitive functioning. The FINGER Study found that by focusing on diet improvement, exercise, cognitive training, vascular management and social activities, at-risk participants in that study effectively improved or maintained cognitive function.
But implementing a multidomain plan—especially for older people—can be challenging since it typically poses considerable burden in terms of cost, transportation and time commitment, and it often requires significant resources from healthcare providers.
That’s why Mindr digitized the methods of the FINGER Study into an easy-to-use app where users can log their activities and responses to these five habits. Mindr also sends out notifications and offers coaches who are available by chat to help keep users on track.
In addition to digitizing the FINGER Study, Mindr also works with providers to focus on mobile based diagnosis, delivering self-screening tools so that people can screen their health on a daily basis. By setting up a telemedicine feature through the app, the screening can identify any problems and then connect the user with a physician right away.
“One screening event isn’t enough to know what’s happening to an overall cognitive assessment,” Schultz said. “But if the patient can do it every three to six months over time, you can see the differences, track that trajectory and catch the symptoms early on, even before a formal MCI (mild cognitive impairment) diagnosis.”
Schultz said that by specifically hitting on the FINGER Study habits, Mindr could tackle and prevent the reported 40% of dementia cases, but they understand that they can’t reach 100% of all cases. But by having real, user-centric data, Mindr can start building relationships with providers to start reaching more cases and to ensure that at-risk users receive the right medicine and care when they need it.
And they’ve already started to collect that data. In late 2022, Mindr launched a 90-day pilot study, which focused on a range of people aged 65-85—30% of which had an MCI—and didn’t implement any personalization per user. They instead offered coaches that helped users stay on track with logging their data and doing their activities.
In those 90 days, Schultz said that the program delivered a lot of similar health outcomes that the FINGER trial showed.
Over 71% of the participants reported memory improvement, 50% saw improvement in the amount of healthy days they had and 65% reported that they engaged in more activities. These results confirmed to Marquard and Schultz that it is possible to deliver a digital dementia prevention and wellness plan to help at-risk individuals without expensive and time-intensive programs.
Because of the success, Mindr is looking to recruit more people to sign up for their beta program and is currently seeking funding to develop and grow a more automated and fully functional MVP. The startup plans to work with insurance companies on a B2B2C, value-based insurance design (VBID) model ,which will directly connect Mindr to users through their insurance policies in order to provide more accurate and cost-effective approaches toward improving their cognitive health.
“Our goal here is to reach people before they have any of these diseases,” Schultz said. “Maybe they’re feeling that their memory isn’t what it used to be or maybe they have a family member who has Alzheimer’s or dementia, any risk factors at all. It would all be enough for them to engage through our platform and receive all the care they would need preventatively until they get to the point where the actual disease state hits.”
