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Screening for cognitive impairment and dementia in the elderly
1Department of Medicine, McMaster University, Hamilton, ON, Canada.
Summary
Current evidence is insufficient to recommend screening for cognitive impairment or dementia in primary care. However, memory complaints and caregiver concerns warrant thorough evaluation and follow-up.
Area of Science:
- Gerontology
- Neurology
- Primary Care Medicine
Background:
- The objective was to review evidence for or against screening for cognitive impairment and dementia in primary care settings.
- The review considered definitions, natural history, interventions, and potential negative effects of screening, as no randomized controlled trials of screening versus no screening were identified.
Framework:
- Evidence was gathered through Medline searches, expert consultations, and review of existing recommendations.
- A panel of experts reviewed background papers before the Canadian Consensus Conference on Dementia, reaching conclusions by consensus.
Implementation:
- No systematic synthesis of evidence was performed.
- Conclusions were endorsed by consensus at the Canadian Consensus Conference on Dementia.
Implications:
- There is insufficient evidence to recommend for or against screening for cognitive impairment or dementia.
- Memory complaints require evaluation and monitoring for progression.
- Caregiver and informant reports of cognitive decline necessitate serious consideration, cognitive assessment, and careful follow-up.