Centering What Matters: Using ePSOM to Align Brain Health Care With Resident Priorities

Please introduce yourself by stating your name, title, and any relevant experience you’d like to share.

Dr Ali Jannati: My name is Ali Jannati, MD, PhD, and I’m the director of cognitive science at Linus Health. My background bridges cognitive neuroscience and clinical research in neurology, with a particular interest in digital health. Over the years, I’ve focused on translating scientific insights into tools that support more meaningful, individualized diagnosis and care, especially in areas where standard approaches may fall short. At Linus Health, our team helps guide initiatives aimed at understanding what really matters to people when it comes to their brain health and how we can better reflect that in both research and care.

Can you provide a brief overview of your study and its importance?

Dr Jannati: This study builds on pioneering work led by my colleague Dr Stina Saunders in the United Kingdom and extends it to a US population. We used the electronic Person-Specific Outcome Measure (ePSOM) to explore what individuals identify as most important in maintaining their brain health, whether that’s driving, cooking, reading, or spending time with loved ones.

What makes this work particularly exciting is that it’s the first effort to assess these self-defined priorities on a large scale in the US. We found notable differences—not just between countries, but also between people with and without neurodegenerative diagnoses.

The ePSOM tool stands out for its ecological validity. Rather than asking participants to rate abstract functions, it invites them to reflect on activities that give their daily lives meaning. It then tracks how confident they feel about maintaining those activities over time. This provides a much richer understanding of functional status—one that more closely mirrors the realities of aging and brain health.

How might the findings from your ePSOM US study influence care planning or shared decision-making in long-term care settings?

Dr Jannati: One of the toughest challenges in long-term care is detecting changes that actually matter to the person receiving care. Standard assessments tend to take a one-size-fits-all approach and often miss shifts in areas such as independence, social engagement, or sense of purpose.

ePSOM helps close that gap. It gives clinicians and care teams a robust way to track personalized priorities and confidence levels over time. For instance, if a patient values being able to hold a conversation or manage their own schedule, ePSOM can help clinicians monitor how well they’re doing in those areas and make adjustments if they see a decline.

This tool also promotes truly shared decision-making. It ensures that care plans evolve based on each person’s goals—not just clinical benchmarks—making them more responsive and person-centered. In complex care environments, such as skilled nursing or assisted living, this level of personalization can make a real difference in both outcomes and quality of life.

With new Alzheimer disease therapies on the market, there’s debate about what constitutes a “meaningful benefit.” How does your research challenge or support current clinical end points used in drug evaluation?

Dr Jannati: That’s such a timely and important question. There’s growing recognition that the traditional outcome measures we’ve used in trials—like cognitive or functional composite scores—may not fully capture how treatments affect people’s real lives. That’s where ePSOM can play a crucial role.

Rather than relying solely on standardized scales, ePSOM allows us to ask, “Is this treatment helping someone hold on to the parts of life that matter most to them?” Whether it’s participating in a book club, going for walks, or staying active in their community, these are meaningful, real-world outcomes.

This approach is also well-aligned with emerging regulatory guidance, including from the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA), both of which emphasize the importance of patient-centered measures. By integrating ePSOM into clinical trials or real-world assessments, we can redefine what “benefit” looks like—not just statistically, but personally.

What are the next steps for the ePSOM initiative in the US? Are there plans to test it in clinical or long-term care environments directly?

Dr Jannati: Yes, we’re actively moving in that direction. The next phase involves longitudinal validation—tracking how ePSOM scores change over several months and whether those shifts correspond to changes in clinical status, care needs, or treatment response.

We’re particularly interested in using ePSOM with individuals who are beginning newly approved Alzheimer disease therapies to see how their confidence and priorities evolve over time. That could offer insight into treatment effects that standard scales might miss.

We’re also working to integrate ePSOM into long-term care settings, where it can support a wide range of decisions—from pharmacological to lifestyle and environmental interventions. Our broader goal is to make this kind of individualized, patient-defined measurement a routine part of clinical workflows, so we can support brain health more holistically, from early risk to late-stage care.