Screening for cognitive impairment in older adults: an evidence update for the U.S. Preventive Services Task Force.
Lin JS, O'Connor E, Rossom R, Perdue LA, Burda BU, Thompson M, Eckstrom E
Record ID 32014000081
English
Authors' objectives:
We conducted this systematic review to support the U.S. Preventive Services Task Force (USPSTF) in updating its recommendation on screening for cognitive impairment in older adults. Our review addresses five questions: 1) Does screening for cognitive impairment in community-dwelling older adults improve decisionmaking, patient, family/caregiver, or societal outcomes?; 2) What is the test performance of screening instruments to detect dementia or mild cognitive impairment (MCI) in community-dwelling older adult primary care patients?; 3) What are the harms of screening for cognitive impairment?; 4) Do interventions for early dementia or MCI in older adults improve decisionmaking, patient, family/caregiver, or societal outcomes?; and 5) What are the harms of interventions for cognitive impairment?
Authors' recommendations:
We found no trial evidence that examined the effect of screening for cognitive impairment on patient, caregiver, or clinician decisionmaking or important patient, caregiver, or societal outcomes. Several brief screening instruments can adequately detect dementia, especially in populations with a higher prevalence of underlying dementia. Despite the size of this body of literature, only a handful of instruments have been studied as screening tests in more than one study. AChEIs, memantine, complex caregiver interventions, and cognitive stimulation all have evidence to support their use in mild to moderate dementia, specifically AD. However, the clinical importance of their benefit is unclear because the average effects of benefit observed in trials was small or had a large amount of imprecision.
Details
Project Status:
Completed
Year Published:
2013
URL for published report:
http://www.ncbi.nlm.nih.gov/books/NBK174643/pdf/TOC.pdf
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Humans
- Mass Screening
- Cognition Disorders
- Aged
- Aged, 80 and over
Contact
Organisation Name:
Agency for Healthcare Research and Quality
Contact Address:
Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name:
martin.erlichman@ahrq.hhs.gov
Contact Email:
martin.erlichman@ahrq.hhs.gov
Copyright:
Agency for Healthcare Research and Quality (AHRQ)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.