Should older adults be screened for dementia? It is important to screen for evidence of dementia!

Abstract

Multiple arguments for considering routine dementia screening have been presented. Furthermore, dementia diagnoses are widely unrecognized. As a result, persons with dementia are missing important clinical care and treatment interventions. By distinction, the problems of defining, diagnosing, and treating mild cognitive impairment (MCI) are not yet resolved, and MCI is not ready for a screening recommendation. Dementia screening approaches, including cognitive testing and functional assessment, must be evaluated on their scientific merits, including sensitivity and specificity for recognizing affected individuals in at‐risk populations. Screening tests must be “cost‐worthy”, with the benefits of true‐positive test results justifying the costs of testing and resolving false‐positive cases, with due consideration for proper diagnostic evaluation and potential harms. With the tremendous number of new cases projected in the near future and the expected emergence of beneficial therapies, considerably more research is needed to develop more efficient screening systems. Editor's Note: This paper was written in response to a comment submitted to this Journal on the consensus statement by a group of scientists concerned about screening for dementia, which was published in this Journal in April 2006 [1]. The submitted manuscript was withdrawn after this response was submitted. However, this response is being published because it addresses concerns about screening recommendations and provides clarification and additional information on key points concerning dementia screening.