universal screening for dementia may do harm

a leading group of medical experts have controversially refused to endorse cognitive screening for older adults, contributing to an ongoing debate within the scientific community.the us preventive services task force has released a report concluding that there was insufficient evidence to make a clear recommendation on cognitive screening for dementia in older adults. they said there was not enough scientific data on the practice’s benefits and harms, calling for more research.the decision comes as concerns grow over rising numbers of people with alzheimer’s disease and other forms of dementia. currently in the us, there are more than 2.4 to 5.5 million american affected by the disease, with that number expected to reach 14 million by 2050.seniors are at a high risk of cognitive impairment. screening people who aren’t showing any symptoms is thought to be a good strategy to identify symptoms that patients may not recognize, leading to better care.screening involves administering short 5 minute tests to determine cognitive ability. it can involve asking people to recall a word, sort items into different categories, or spelling a word backwards among other tasks. the idea is that these tests can shed light on problems related to memory and thinking that otherwise would go unnoticed.however, opposers say that the benefits of screening are unproven, and the results can be potentially harmful.“getting a positive result can make someone wary about their cognition and memory for the rest of their life,” benjamin bensadon, an associate professor of geriatric medicine at the university of florida college of medicine, told khn.the task force’s evaluation focused on the concept of ‘universal screening,’ particularly whether all adults age 65 and older without symptoms should be tested to analyze their cognition. the report found a lack of scientific evidence that the cognition tests would improve older adults’ quality of life, ensure they receive better care, or positively affect other areas such as their wellbeing.their stance is controversial, as healthcare service providers routinely overlook dementia and cognitive development problems in older adults. many studies show that 50 per cent of the time, medical professionals fail to recognize these conditions.dr. ronald petersen, co-author of an editorial accompanying the recommendations, told the los angeles times that these findings shouldn’t discourage doctors from investigating their patients’ memory and thinking.“there is increased awareness, both on the part of patients and physicians, of the importance of cognitive impairment,” said petersen, director of the mayo clinic’s alzheimer’s disease research center. “it would be a mistake if physicians didn’t pay more attention to cognition and consider screening on a case-by-case basis.”older adults and their families also need to address worrying symptoms.“if someone has concerns about their memory or cognitive abilities, they should certainly discuss that with their clinician,” dr. douglas owens, chair of the task force and a professor at stanford university school of medicine told the los angeles times.while it’s critical to talk to your doctor if you are worried about your memory or cognition, or that of a loved one, there can be a lot of fear around exploring the possibility that something is wrong. this fear often results in a reluctance to seek help.“there are ways that we, as physicians, can work around that,” dr. timothy holden, a geriatric medicine specialist at washington university school of medicine in st. louis told the los angeles times. “if a physician handles the situation with sensitivity and takes things one step at a time, you can build trust and that can make things much easier.”