The new health law requires Medicare to cover screening for cognitive impairment during an annual wellness visit, however, a new study found that there is not enough evidence to recommend dementia screenings during wellness visits for people older than 65. Albert Siu, Professor and Chair of Geriatrics and Palliative Care at Mount Sinai School of Medicine in New York and a leader of the task force on dementia screening, said, “Clinicians need to use their judgment. The evidence isn’t clear that there is a net benefit to screening for individuals that are asymptomatic.”
For the study, the U.S. Preventive Services Task Force, a group of medical experts, evaluated the benefits, harms and clinical utility of screening instruments for cognitive impairment. Researchers concluded that there was insufficient evidence for routine population-based screenings but did note that some screening tools may be useful in identifying dementia.
However, the Alzheimer’s Association recommends that seniors undergo cognitive impairment screenings to establish a baseline and then continue follow-up assessment in the future. Dean Hartley, Director of Science Initiatives at the Alzheimer’s Association, says it is important that the test be taken in medical settings with a trained professional, since someone who does poorly on the test could have other medical conditions.
The key argument against routine screening for cognitive impairment is that, “We don’t have studies that show that such a screening program improves the care of people with dementia,” says Ariel Green, a geriatrician at Johns Hopkins Bayview Medical Center. Although research has not yet shown screenings effective at improvement overall dementia care, it may still help families and individuals identify cognitive impairment and dementia early on. In addition, Green says, “it’s helpful for people to hear a diagnosis of dementia, if it’s an accurate diagnosis, because it can help people anticipate their future needs and plan for that.”