USPSTF: Insufficient evidence to evaluate benefits, harms of screening for cognitive impairment
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The U.S. Preventive Services Task Force wrote in JAMA that there is insufficient evidence to assess the benefits and harms of screening for cognitive impairment — its collective term for dementia and mild cognitive impairment — in older adults.
However, the task force stated that physicians should continue to assess cognitive abilities in these patients.
“Clinicians should remain alert to early signs or symptoms of cognitive impairment — eg, problems with memory or language — and evaluate the individual as appropriate,” the task force wrote.
In a related editorial, Ronald C. Petersen, PhD, MD, director of the Mayo Clinic Alzheimer's Disease Research Center, and Kristine Yaffe, MD, professor at the University of California, San Francisco Weill Institute for Neurosciences, said it would be a “mistake” if primary care physicians did not consider screening older adults for cognitive impairment on a case-by-case basis.
"With the development of disease-modifying therapies for some of the underlying neurodegenerative diseases that contribute to cognitive impairment, the importance of screening will become increasingly apparent," Petersen and Yaffe wrote.
A previous JAMA report indicated that 10% to 20% of all adults aged 65 years and older have mild cognitive impairment.
Although the evidence was insufficient to make a recommendation, the USPSTF noted that it has issued recommendations regarding several risk factors associated with cognitive impairment, including tobacco use, unhealthy diet, lack of physical activity, unhealthy alcohol use, CVD, abnormal blood glucose levels, depression and hypertension.
The USPSTF sought to update recommendations that it made in 2014. To do so, it reviewed 287 studies, which included more than 280,000 older adults, researchers said. A draft version of the task force’s final recommendation statement was posted for public comment in September 2019. by Janel Miller
References:
Langa LM and Levine DA. JAMA. 2014;doi:10.1001/jama.2014.13806.
Patnode C, et al. JAMA. 2020;doi:10.1001/jama.2019.22258.
Petersen RC, Yaffe K. JAMA. 2020;doi:10.1001/jama.2019.22527.
United States Preventive Services Task Force. JAMA. 2020;doi:10.1001/jama.2020.0435.
Disclosures: One of the authors of the review reports receiving grants from the NIH and FDA. All members of the USPSTF receive travel reimbursement and an honorarium for participating in USPSTF meetings. Please see the editorial for Petersen and Yaffe’s relevant financial disclosures.