Routine Dementia Screening Has No Proven Benefit

Although screening for cognitive impairment can successfully identify patients with early-stage dementia, the benefits of such screening remain unproven, according to a new meta-analysis for the US Preventive Services Task Force (USPSTF).

Noting that the issue was last addressed by the USPSTF in 2003, when the agency found that there wasn’t enough evidence for or against the screening, Jennifer Lin, MD, MCR, of the Kaiser Permanente Center for Health Research Northwest in Portland, OR, and colleagues reviewed more than 300 studies for their research published in the online Annals of the Internal Medicine.

Lin and her co-authors weren’t enthusiastic about the clinical significance of the effects of anti-dementia medications approved by the US Food and Drug Administration (FDA), such as donepezil, galantamine, rivastigmine, and memantine — even though the study found that those medications improved cognitive performance in patients with dementia.

“The average effects of the changes in cognitive functioning observed in trials are small, and the clinical important of population benefits is probably negligible,” the authors wrote. The researchers also said that interventions at the stage of mild impairment also appeared to have minimal benefit with respect to caregiver burden. Therefore, they concluded that there’s no empirical evidence on whether the interventions affect clinician, patient, or family decision-making about dementia.

Likewise, studies of non-pharmacologic interventions for patients, such as physical or mental exercises, have had inconsistent results. While primary care instruments for detecting early-stage dementia are available, it remains unclear whether they should be used on a routine basis, the authors concluded.