To Screen for Dementia or Not

Dementia screening tests might not help general population fare any better after expense

(RxWiki News) Routine screening for certain diseases comes with aging. But among the general population, pricey screening tests for dementia may not provide any real benefit for seniors who are not at risk.

A team of public health researchers looked at the costs of screening for dementia in the general population and whether or not the screenings benefited seniors in the general population.

The results showed that the screenings are expensive and time consuming, and didn’t really improve physical or mental health in the overall senior population.

"Don’t stress about Alzheimer’s screening tests."

Carol Brayne, MD from the Cambridge Institute of Public Health at Cambridge University in the UK, presented these findings on routine screening practices for dementia in the general population at the Alzheimer’s Association International Conference.

Previous research estimated that as many as half of the people with dementia had not been officially diagnosed, or they received a diagnosis of dementia after the disease had really taken hold.

The high rate of undiagnosed dementia begs the question: should all seniors be screened for dementia?

Screening for dementia can cost both valuable time and money in the healthcare field.

Dr. Brayne’s research team set out to investigate whether the benefit of screening for dementia in the general population would outweigh the costs.

The researchers looked through multiple studies that tested screening practices for dementia in general care settings. They also looked at studies on routine care for seniors, without screening for dementia, at general practitioner’s offices and at community clinics.

All of the studies they looked at were published in peer-reviewed journals before May 2012.

The results of the investigation showed that screening seniors in the general population had no impact on the following:

  • Mental and emotional health
  • Thought function and mental sharpness
  • Social functioning and planning

The researchers found six studies that looked at the cost of screening for dementia. The results showed that the costs of screening were "substantial." The cost of screening for dementia increased if the population was older, if the screening tools were expensive and if the healthcare providers spent time following up with the patients.

These studies were not evaluating screening practices for seniors with symptoms of dementia or at risk for developing dementia. They were only evaluating screening practices for seniors undergoing routine care at a general practicioner's office or clinic.

The researchers did not find any studies that showed routine screenings harmed seniors by increasing anxiety, depression or feelings of social stigma after being labeled with a dementia diagnosis.

The results of this study did not show any proof that screening seniors in the general population would improve their physical or mental health or social situations, Dr. Brayne said in a press release.

“This study is important because it indicates that screening of the general population for dementia shows no benefit at the present time.  While we have the ability to screen people for dementia, this should be done only in the presence of symptoms being voiced by the patient or family. Knowing that general dementia screening for all seniors doesn't offer any benefit can save a significant amount of money, resources and time for both the healthcare system and patients," Dr. Bryan Spann, clinical director, Nantz National Alzheimer Center at Houston Methodist Neurological Institute, told dailyRx News. 

"Policymakers should be very cautious about adopting population screenings for dementia without any evidence of benefits or risks," Dr. Brayne said.

"Dr. Brayne's study should allow seniors to feel confident that if they're not experiencing signs or symptoms of dementia, do not exhibit risk factors such as hypertension, diabetes, high cholesterol, obesity, prior head trauma and sleep apnea and don't have any family history, their time with their primary care doctor can be best utilized focusing on other equally important medical issues,” said Dr. Spann.

These trial results were presented at the Alzheimer’s Association International Conference in Boston, MA, July 13-18, 2013.  This information was presented at a conference and has not been published in a peer-reviewed journal.

No funding information was made available by the presenters.

Review Date: 
July 17, 2013