Cognitive Health in the WorkplaceDr Jenny Barnett
Director, Healthcare Innovation
Mild Cognitive Impairment:
Uncovering the Impact on an Ageing Workforce
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CANTAB Corporate Health
Validated by 30 years of leading neuroscience research from Cambridge
Cognition, the leading global provider of cognitive assessment software in:
• Academic Research : 1,500+ published studies worldwide
• Clinical Drug Trials : 162 global trials
• Healthcare Provision: 25,000+ NHS assessments
Combining leading neuroscience and expertise in occupational health.
Helping employers and providers measure and manage cognitive health
using the latest digital tools.
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What is cognition?
Memory & learning
Remember contacts, actions appointmentsLearn new names, procedures, systems
Attention
Ability to concentrateJuggle competing demands
Processing speed
Rapidly understanding information
Decision-making
Weigh up evidence Risk- and time- appropriate decisions
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Everyd
ay m
em
ory p
ro
ble
m q
uesti
on
nair
e
CANTAB PAL total trials adjusted
120
100
80
60
40
20
0
120 10 20 30 40 50 60 70
• Stockbroker taking inappropriate financial risks
• Air traffic controller responding too slowly to an emerging risk
• Sales lead forgetting contacts or failing to follow up on agreed actions
• Programmer writing poor code
R=0.686; p<0.001
Real-world consequences of cognitive failures
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Mild cognitive impairment (MCI)
• Impaired cognitive function in one or more domains• Milder than dementia, does not prevent independent functioning• A noticeable change from previous levels of functioning
MCI can be due to reversible causes such as
• Stress, anxiety or depression• Physical illness such as thyroid problems• Side-effects of medication
However, 70% eventually get diagnosed with a dementia.
Already, people aged 50+ represent 32% of working age population (ONS)
Much neurodegenerative disease takes hold in mid-life, many years before any obvious symptoms.
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Cantab MobileMemory and mood assessment for ages 50+
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400+GP Surgeries
Across 40Healthcare Authorities
25,000+cognitive assessments
Detecting dementia
earlier
Saving NHSTime & Cost
Memory impairment present in around
1 in 4 people
Early access to support
Most people reassured
avoiding referrals and costs
Usage in the NHS
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3 out of 4 people would want to know if they were at risk of a neurological disorder
GE Healthcare: The Value of Knowing. Millward Brown, 2014
Benefits of early detection at work
Practical benefits
Reduces risk to the business and the individual
Enables proper and effective planning
Reduces uncertainty and distress
Lower diagnostic and treatment costs
Improved effectiveness of treatments
Timely advice and support
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Paired Associates Learning (PAL)
Spatial Working Memory (SWM)
Matching to Sample (MTS)
Episodic Memory Working Memory Executive Function
Age, Education and Gender adjustment
Processing Speed Attention
Total errors Total Errors Strategy Score Proportional Slowing
% Correct% Correct
Mood
Score
Depression Scale
CANTAB Insight20-minute assessment for ages 18+
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Reporting 5 cognitive functions across 6 levels of performance, adjusted for age, sex and education level
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Common Causes of Cognitive Impairment
1. Royal College of Psychiatrists Position statement PS4/2010 2. NIMH, USA 3. McManus S, Meltzer H, Brugha T, et
al (2009) 4.HSE Work related Stress, Anxiety and Depression Statistics in Great Britain 2015 5.Mar et al (2015)
Spanish data
Recreational substance abuse
Depression, Anxiety,Stress
Early AD
24% have hazardous patterns of drinking6% alcohol dependence3% drug dependence1
Major depression: ~7% each year2
Common mental disorder: 18%3
43% of sick days due to stress4
½ of people over 60 are in early stages of AD but less than ½ will ever reach dementia5
Memory, New learning Executive function, attention, memory –some improvement with treatment
Learning and memory, impulse control and decision-making
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Managing existing conditions aids cognition
Improvements after 6-months of antidepressant treatment
0
5
10
15
20
25
30
35
40
45
50
Duloxetine Escitalopram
Pre-treatment
Post-treatment
To
tal erro
rs (
SW
M)
Egerhazi et al., Neuropsych Hungar, 2013; see also Rock et al., Psych Med, 2013; Herrera-Guzman et al., Psych Res, 2010
Ryan et al (2006)
Improvements after 6-months of treatment for type 2 diabetes
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Side effects of common drugs
Effects of single-doses of medication in healthy volunteers.
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What Is Measured Can Be Managed
Physical & brain health are inextricably linked
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Memory concerns are common –but technology allows easy, accurate measurement
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Managing brain health better would have a huge impact on our workforce
A small shift in mean substantially decreases the number of people who are cognitively impaired and increases those functioning at peak performance.
Makes Sense.
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