Screening for cognitive impairment and dementia in the elderly

Objective: To review the evidence available to support or refute the recomm endation to screen for cognitive impairment (cognitive deficits which do no t affect daily function) and dementia in primary care, Data Sources: Medlin e search using terms listed at the end of this article: consultation with e xperts in the field; review of other published recommendations. Study Selec tion: 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 p ossible negative effects. Data Synthesis: No systematic synthesis was perfo rmed. Background papers were circulated to a panel of experts prior to the Canadian Consensus Conference on Dementia and conclusions endorsed by conse nsus. Conclusions: 1. There is insufficient evidence to recommend for or ag ainst screening for cognitive impairment or dementia, (C); 2. Memory compla ints should be evaluated and the individual followed to assess progression. (B); 3, When caregivers or informants describe cognitive decline in an ind ividual, these observations should be taken very seriously; cognitive asses sment and careful follow-up are indicated. (A) (See Appendix).