Not Enough Info to Recommend Routine Dementia Screening

Routine screening for cognitive decline not recommended but doctors should still look for signs of cognitive problems

(RxWiki News) Although mental decline in old age is common, the exact rate is still not known. It also remains unclear when people should get screened for mental decline.

The U.S. Preventive Services Task Force (USPSTF) recently concluded that there was not enough evidence on the effectiveness of primary care-based, routine screening for cognitive decline (loss of basic mental function) in older adults.

The Task Force recommended that doctors should still pay attention to early signs or symptoms of cognitive impairment, such as memory loss or problems with language, and assess their patient as needed.

"Talk to your doctor about the signs of cognitive impairment."

The lead author of this recommendation was U.S. Preventive Services Task Force Chair Virginia A. Moyer, MD, MPH, of the American Board of Pediatrics.

This is an update to the 2003 USPSTF recommendation on screening for dementia

The USPSTF considered new information on the test performance of screening instruments that was not available or considered in 2003. The Task Force determined that there is enough information on the test performance of some screening tools' ability to detect impairment.

This recommendation only applies to universal screening with formal screening instruments in community-dwelling (not in an assisted living home or hospital) adults over the age of 65 years old who show no signs of cognitive impairment and are under the care of a primary doctor.

If signs of impairment are recognized by a physician, family or patient, it is not considered screening and is not the focus of this recommendation.

This recent update also differs from the 2003 recommendation because it considers the evidence on screening for and treatment of mild cognitive impairment (MCI) in addition to dementia.

Dementia is a general term used to describe a decline in mental ability severe enough to interfere with daily life. The condition currently affects up to 5.5 million Americans and its prevalence increases with age.

MCI is a type of mental decline that is not severe enough to interfere with the necessary activities of living an independent life. The authors revealed that the prevalence of MCI in the United States is unknown, but the condition is estimated to affect between 3 and 42 percent of adults aged 65 years and older.

Ultimately, the Task Force concluded that there was not enough evidence to adequately assess the benefits versus the risks of regular screening for cognitive impairment for older adults in a primary-care setting.

This recommendation statement was published on March 24 in the Annals of Internal Medicine.

Review Date: 
March 24, 2014