Would routine testing for dementia identify potential sufferers before they or their families realise they are affected?

In findings published last year, a US team assessed the impact of screening – coupled with further evaluation – on diagnoses in veterans aged 70 and older who had no indication of memory loss. Participants were given a brief test, in which they had to perform tasks such as drawing a clock and recalling certain words. Of the 8,063 people who accepted screening, 2,081 failed and 580 agreed to further evaluation. In total, 902 – or 11% – of people were diagnosed with cognitive impairment, compared with 4% in clinics without the program, the researchers said. Among those who failed the screening and accepted further evaluation, 432 were diagnosed with dementia. Of 118 patients who passed the initial screen but still requested further evaluation, 82 were diagnosed with dementia.

While this study illustrated that persons who self-described as non-symptomatic could in fact be suffering from cognitive impairment, it raises important questions about the value and risks of screening. Evidence is emerging that early diagnosis and intervention could have some positive effect on outcomes. Still, the question exists on whether the cost of additional screening of false positives is offset by savings from early intervention. The researchers, led by Dr. JRiley McCarten, suggest that further investigation is needed to draw conclusions.

The findings were published in the Journal of the American Geriatrics Society.