Screening for cognitive impairment in older adults : an evidence update for the U.S. Preventive Services Task Force

OBJECTIVE: We conducted this systematic review to support the U.S. Preventive Services Task Force (USPSTF) in updating its recommendation on screening for cognitive impairment in older adults. Our review addresses five questions: 1) Does screening for cognitive impairment in community-dwelling older...

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Main Author: Lin, Jennifer
Corporate Authors: United States Agency for Healthcare Research and Quality, Oregon Evidence-based Practice Center (Center for Health Research (Kaiser-Permanente Medical Care Program. Northwest Region))
Format: eBook
Language:English
Published: Rockville, MD Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services 2013, November 2013
Series:Evidence syntheses
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
Summary:OBJECTIVE: We conducted this systematic review to support the U.S. Preventive Services Task Force (USPSTF) in updating its recommendation on screening for cognitive impairment in older adults. Our review addresses five questions: 1) Does screening for cognitive impairment in community-dwelling older adults improve decisionmaking, patient, family/caregiver, or societal outcomes?; 2) What is the test performance of screening instruments to detect dementia or mild cognitive impairment (MCI) in community-dwelling older adult primary care patients?; 3) What are the harms of screening for cognitive impairment?; 4) Do interventions for early dementia or MCI in older adults improve decisionmaking, patient, family/caregiver, or societal outcomes?; and 5) What are the harms of interventions for cognitive impairment? CONCLUSIONS: We found no trial evidence that examined the effect of screening for cognitive impairment on patient, caregiver, or clinician decisionmaking or important patient, caregiver, or societal outcomes. Several brief screening instruments can adequately detect dementia, especially in populations with a higher prevalence of underlying dementia. Despite the size of this body of literature, only a handful of instruments have been studied as screening tests in more than one study. AChEIs, memantine, complex caregiver interventions, and cognitive stimulation all have evidence to support their use in mild to moderate dementia, specifically AD. However, the clinical importance of their benefit is unclear because the average effects of benefit observed in trials was small or had a large amount of imprecision
Item Description:Title from PDF title page
Physical Description:1 PDF file (xii, 403 pages) illustrations