Recommendations on screening for cognitive impairment in older adults.
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• No randomized trials have evaluated the benefits of screening for cognitive impairment. • Available data suggest that pharmacologic treatments are not effective in people with mild cognitive impairment and that nonpharmacologic therapies (e.g., exercise, cognitive training and rehabilitation) produce only small benefits, which do not appear to be clinically significant.
• Existing studies suggest that about 1 in 10 people without cognitive impairment may erroneously screen positive for mild cognitive impairment using the Mini-Mental State Examination and that 1 in 4 people may incorrectly be classified as positive using the MontrealCognitive Assessment tool.
• The task force recommendation against screening asymptomatic adults 65 years of age and older for cognitive impairment is based on the lack of high-quality studies evaluating the benefits and harms of screening for
cognitive impairment, on evidence showing that treatment of mild cognitive impairment does not produce clinically meaningful benefit and on the potentially high rate of false-positive screens that may occur.
• The strong recommendation against screening asymptomatic adults 65 years of age and older for cognitive impairment implies that the task force is confident that most individuals will be best served by the recommended course of action.
• Practitioners should consider cognitive assessment for patients withsigns and symptoms of impairment or when family members or patients express concerns about potential cognitive decline.
Resource: CMAJ. 2016 Jan 5;188(1):37-46.