USPSTF: Routine Cognitive Screening for Elderly Unnecessary

There is no current evidence that supports routine screening for cognitive impairment among patients 65 years and older and the risk of screening may outweigh the benefits, according to the US Preventive Services Task Force (USPSTF).

In 2003, the USPSTF concluded that there was not enough evidence to make recommendations either for or against the screening of older adults for dementia.
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In an effort to further investigate this issue, the task force reviewed 55 studies on the accuracy of dementia screening instruments and 130 studies of dementia treatment strategies, finding that “no studies directly evaluated the benefits and harms of screening for cognitive impairment.”

There was evidence that screening methods can effectively identify cognitive impairment, but the effects of drug treatments for dementia are “not enough to meaningfully affect patient function.”

Therefore, the task force’s stance remains the same as in 2003.  This puts the group at odds with the Alzheimer’s Association and their guidelines urging Medicare enrollees to take advantage of their coverage and undergo screening each year.

This lack of recommendations, the USPSTF stressed, applies only to older adults showing no symptoms of cognitive decline.

“If patients or their relatives notice memory problems, they should tell their doctors because testing for cognitive impairment may be indicated.”

–Michael Potts

Screening for Cognitive Impairment in Older Adults: U.S. Preventive Services Task Force Recommendation Statement [published online ahead of print March 25, 2014]. Ann Intern Med. doi:10.7326/P14-9017