Tuesday, March 25, 2014

Task Force Finds Insufficient Evidence to Recommend Screening Adults for Cognitive Impairment


The United States Preventive Services Task Force (USPSTF) has concluded that evidence is insufficient to assess the benefits and harms associated with screening adults for cognitive impairment or dementia.

In clinical guidelines published online in the Annals of Internal Medicine, the task force said that there is not enough evidence to recommend widespread screening of adults for cognitive decline and dementia. Task force members reviewed the data on the benefits, harms, and sensitivity and specificity of screening instruments for cognitive impairment in older adults and of commonly used treatment and management options for older adults with mild cognitive impairment or early dementia and their caregivers.

“Evidence is adequate that some screening tools can accurately identify dementia," the report noted. "Treatment of mild to moderate dementia with several drug therapies and nonpharmacologic interventions results in small improvements in measures of cognitive function and caregiver outcomes, but the clinical significance of these improvements is uncertain. The USPSTF found no published evidence on the effect of screening on decision making or planning by patients, clinicians, or caregivers. Evidence on the harms of screening and nonpharmacologic interventions is inadequate…. Overall, the USPSTF was unable to estimate the balance of benefits and harms of screening for cognitive impairment.”

This recommendation applies to universal screening with formal screening instruments in community-dwelling adults who are older than age 65 and have no signs of cognitive impairment.

For more information see the Psychiatric News article, “Plasma APOE Levels Linked to Dementia Risk.”

(Image: Alexander Raths/shutterstock.com)

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