MONDAY, Nov. 4 (HealthDay News) -- Physicians give screening
tests to older adults who show signs of mental decline, and some
experts have theorized that all seniors might benefit from routine
But proposed guidelines from a U.S. government-appointed panel
says not enough evidence exists to say yes or no to such a
It's still not clear whether the risk of false results and the
lack of treatments available to help people with dementia outweigh
the benefits associated with early identification, said Dr. Albert
Siu, co-chair of the U.S. Preventive Services Task Force, which
released the draft recommendations Monday.
Thinking and memory problems related to aging "are a very common
and quite devastating problem, especially among 80-year-olds," Siu
said. "We believe that doctors should remain alert to signs and
symptoms in the course of their evaluation. If they see anything,
they should screen for cognitive impairment."
The task force is updating its 2003 guidelines on screening
older people for thinking problems and will make a final decision
Siu, chair of geriatrics and palliative medicine at Mount Sinai
Hospital in New York City, emphasized that the guidelines refer
only to patients who don't show symptoms of problems with thinking
"If somebody has symptoms or their family has issues, this doesn't apply to them. They should bring them up with their doctor," Siu said.
"This is about those who have no complaints or issues. The question is whether screening should be done routinely in the doctor's office," he explained.
An estimated 2.4 million to 5.5 million Americans have dementia,
which impairs their ability to function socially and on the job.
The condition becomes more common with age, affecting one in 20
people aged 71 to 79, about one-quarter of those in their 80s and
more than one-third of people in their 90s or older.
The draft guidelines say that screening tests are able to detect
dementia. The question is whether patients would benefit from early
identification of mental decline. The guideline authors write that
it's unclear whether existing treatments have a significant effect
on mild to moderate dementia.
A review of existing studies, treatments and diagnostic tools
also found no medical proof that earlier detection of age-related
brain decline helps improve decision-making about a patient's
It's uncommon for physicians to screen for thinking problems
unless they're neurologists or psychiatrists, said Dr. P. Murali
Doraiswamy, professor of psychiatry at Duke University Medical
Center in Durham, N.C. "Even pilots or surgeons or presidents who
get physical exams rarely get routine memory tests," he said.
There can be potential benefits to catching thinking problems,
however. Doraiswamy said memory loss itself can be caused by other
conditions that are reversible, including thyroid problems,
depression, stress, anxiety and sleep problems.
Dr. Philip Gorelick, a stroke specialist and professor of
translational science and molecular medicine at Michigan State
University College of Human Medicine, agreed. Early detection would
allow enrollment in research studies for those with mild thinking
problems, Alzheimer's disease or slight thinking problems due to
blood flow issues in the brain. And, he said, Alzheimer's patients
could benefit from treatment for symptoms.
The task force said little is known about the harms of routine
screening and suggested more research be done before routine
screening becomes standard.
Doraiswamy said the task force's position on screening could
change if a treatment is shown to prevent dementia, postpone its
onset or stop it in its tracks.
For details about
dementia, visit the U.S. National Library of Medicine.
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