THE USE OF SCREENING INSTRUMENTS FOR THE DETECTION OF DEMENTIA

Dementia is a clinical and public health issue of growing importance a s life expectancy increases across the planet. Despite advances in bot h genetic research and clinical management strategies, neither cure no r primary prevention is currently feasible. However, screening for dem entia is critical for secondary prevention, i.e., early diagnosis and treatment as well as disability limitation and prevention of complicat ions. Screening is also important for community surveillance and the p lanning of health and human services. The most appropriate screening a pproach for a particular clinical or research setting should be select ed on the basis of the purpose of screening in that setting. Ideally, all elderly individuals, as well as younger persons with known risk fa ctors, should be routinely screened for dementia. Availability of staf f resources, including time and skills, should also be taken into acco unt. Objective cognitive testing appears to be the most logical approa ch to screening for dementia. However, potential confounding variables and psychometric properties of the instruments should be considered. Ancillary measures such as functional disability scales, self-reported cognitive functioning, and informants' perceptions may usefully suppl ement (or supplant) cognitive testing in certain populations. The limi tations of screening should be recognized.