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Screening for Cognitive Impairment and Dementia in the Elderly

  • Christopher J.S. Patterson (a1) and David A. Gass (a2)

Abstract

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.

Data Sources:

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

Study Selection:

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.

Data Synthesis:

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.

Conclusion:

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).

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References

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1. CMACPG Infobase: http://www.cma.ca/cpgs
2. National Library of Medicine for Clinical Practice Guidelines: http://text.nlm.nih.gov/
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