Recognizing the Need for Dementia Screening
According to a recent review for the U.S. Preventive Services Task Force (USPSTF), the benefits of screening tests for cognitive impairment are unproven. The effects of clinical intervention to improve cognitive functioning have often been found to be insignificant or even negligible. Similarly, in areas like caregiver burden, there is minimal benefit with interventions at the stage of mild impairment.
Mark Mapstone, PhD, a neurologist at the University of Rochester in N.Y., told MedPage Today in an email that the lack of clear benefit reflects “primary failure of the interventions themselves.” He added, “Until we have effective, disease-modifying interventions at our disposal, the utility of cognitive screening in the primary care setting will remain low.”
According to Jennifer S. Lin, MD, MCR, of Kaiser Permanente Center for Health Research Northwest, in Portland, Ore., and colleagues online in Annals of Internal Medicine, “There is no empirical evidence that screening for or early diagnosis of cognitive impairment improves decision-making or important patient, caregiver, or societal outcomes.”
Although the research would indicate that screening tests for dementia in early stages are not always beneficial, physicians should certainly not ignore signs of dementia. “The distinction between screening and diagnosis is fundamentally important,” said David Knopman, MD, of the Mayo Clinic in Rochester, Minn., “Physicians must recognize that when a person brought to them … complaining about cognitive impairment, or the physician detects the cognitive impairment, or the family detects the cognitive impairment, it can’t be ignored.” If there are indications, other than age, to suspect cognitive impairment, a physician should screen the patient for dementia.
Once a family is aware of what they are facing, they can make informed decisions about their long term care plans. LTCAdministrator.com has networked with first-class health care facilities, many of which offer dedicated dementia or memory care units. Some facilities in particular that have remarkable programs for seniors with dementia are The Waterford on the Bay Senior Living (Brooklyn, NY), Briarwood Healthcare and Rehabilitation Center (Needham, MA) and Water’s Edge Healthcare & Rehabilitation Center (Trenton, NJ).