Population screening and the early detection of dementing disorders in old age: a review

The scope for the early detection of dementing disorders in the elderly by means of screening techniques is reviewed in the light of the basic principles of early disease detection. It is concluded that, while there is an increasingly urgent need for the development and application of psychogeriatric screening methods as a step towards preventive action, such methods are still at an early experimental stage. Prescriptive screening programmes are contra-indicated at present. The most immediate requirement is for evaluative research, which should be planned to take account both of the properties of the screening instruments and of the health-care and social settings in which these are to be applied. No major progress in this field can be expected unless it proves possible to integrate methods of early case-detection, and of systematic surveillance of the at-risk elderly, into the work of primary medical and social services.