What treatment plan should be implemented for a patient with a significant medical condition based on the findings and recommendations of their Creyos Clinical Report?

Creyos Clinical Report: Treatment Planning Based on Cognitive Assessment Findings

I cannot provide a specific treatment plan without knowing the actual clinical findings from the Creyos report and the underlying medical condition being assessed.

Understanding Creyos as a Cognitive Assessment Tool

Creyos is a computerized cognitive testing battery used to measure cognitive function, not a diagnostic tool that directly dictates treatment plans. 1 The clinical utility and treatment implications depend entirely on:

• The specific cognitive domains affected (memory, attention, executive function, processing speed)
• The underlying medical condition being monitored (stroke, schizophrenia, dementia, metabolic disease, etc.)
• The severity of impairment relative to normative data
• The clinical context in which testing was performed

Key Limitations of Remote Cognitive Testing

Remote cognitive testing, including computerized batteries like Creyos, has significant feasibility challenges that affect interpretation: 1

• Only 31% completion rate in acute stroke trial populations
• Older patients (OR: 0.95 per year) are less likely to complete testing 1
• Patients with functional impairment (mRS 2-5) have lower completion rates (OR: 0.66) 1
• Computer literacy significantly predicts completion (OR: 1.12) 1
• Worse quality of life correlates with lower completion rates 1

Treatment Planning Framework by Clinical Context

If Assessing Post-Stroke Cognitive Impairment:

• Cognitive remediation is not standard for stroke-related cognitive deficits (evidence primarily exists for schizophrenia) 2
• Focus on rehabilitation services: physical and occupational therapy during hospitalization with cardiac rehabilitation referral at discharge 2
• Address modifiable risk factors: optimize blood pressure control, lipid management, and diabetes control to prevent further cognitive decline 2

If Assessing Schizophrenia-Related Cognitive Deficits:

Cognitive remediation should be implemented as it produces meaningful benefits in cognition and functioning. 2

• Include all core elements: computer-based training, strategy coaching, and integration with psychiatric rehabilitation 2
• Duration matters: longer treatment duration produces greater functional gains 2
• Not overly influenced by patient characteristics: viable option for most individuals, including clinically compromised patients 2

If Assessing Metabolic Disease-Related Cognitive Decline:

• Diabetes more than doubles the risk of Alzheimer's disease and vascular dementia 2
• Optimize glycemic control: though intensive control hasn't shown cognitive benefit, post-hoc analyses suggest blood pressure control may help 2
• Address hearing loss: increases cognitive impairment risk 2
• Prevent severe hypoglycemia: recurrent episodes increase cognitive impairment risk 2

Critical Clinical Pitfalls

Do not use Creyos results in isolation to make treatment decisions. The cognitive assessment must be integrated with:

• Complete medical history and neurological examination
• Functional status assessment (activities of daily living)
• Quality of life measures 2
• Underlying disease severity and trajectory
• Patient-specific treatment goals 2

Recognize selection bias in who completes remote testing: patients who cannot complete computerized cognitive testing may represent those with more severe impairment who need intervention most urgently. 1

Next Steps for Clinical Decision-Making

To provide a specific treatment plan, the following information is essential:

1. What medical condition is being monitored with Creyos?
2. What specific cognitive domains showed impairment?
3. What is the severity of impairment (percentile scores, standard deviations from norm)?
4. What is the patient's functional status and quality of life?
5. What are the patient's treatment goals and priorities? 2

Quality-of-life assessment should be performed at each visit to determine if treatment goals are being met, and this should influence the intensity and duration of treatment. 2