Screening for cognitive impairment and dementia in the elderly.
OBJECTIVE
To review the evidence available to support or refute the recommendation to screen for cognitive impairment (cognitive deficits which do not affect daily function) and dementia in primary care.


METHODS
Medline search using terms listed at the end of this article; consultation with experts in the field; review of other published recommendations.


METHODS
There were no articles which described a randomized controlled trial of screening versus no screening. Studies were therefore chosen which aided in the definition; natural history; interventions and outcomes including possible negative effects.


RESULTS
No systematic synthesis was performed. Background papers were circulated to a panel of experts prior to the Canadian Consensus Conference on Dementia and conclusions endorsed by consensus.


CONCLUSIONS
1. There is insufficient evidence to recommend for or against screening for cognitive impairment or dementia. (C); 2. Memory complaints should be evaluated and the individual followed to assess progression. (B); 3. When caregivers or informants describe cognitive decline in an individual, these observations should be taken very seriously; cognitive assessment and careful follow-up are indicated. (A) (See Appendix).
Department of Medicine, McMaster University, Hamilton, ON, Canada.
C J
CJ
Patterson
D A
DA
Gass
D000368:Aged / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged