Cognitive Impairment in Older Adults: Screening
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Screening for Cognitive Impairment in Older Adults : Clinical Summary of USPSTF Recommendation
|Population||Community-dwelling adults who are older than age 65 years and have no signs or symptoms of cognitive impairment|
Grade: I statement
|Risk Assessment||Increasing age is the strongest known risk factor for cognitive impairment. Other reported risk factors for cognitive impairment include cardiovascular risk factors (such as diabetes, tobacco use, hypercholesterolemia, and hypertension), head trauma, learning disabilities (such as Down syndrome), depression, alcohol abuse, physical frailty, low education level, low social support, and having never been married.|
Screening tests for cognitive impairment in the clinical setting generally include asking patients to perform a series of tasks that assess 1 or more cognitive domains (memory, attention, language, and visuospatial or executive functioning). The most widely studied instrument is the Mini-Mental State Examination.
Other instruments with more limited evidence include the Clock Draw Test, Mini-Cog, Memory Impairment Screen, Abbreviated Mental Test, Short Portable Mental Status Questionnaire, Free and Cued Selective Reminding Test, 7-Minute Screen, Telephone Interview for Cognitive Status, and Informant Questionnaire on Cognitive Decline in the Elderly.
|Treatment||Pharmacologic treatments approved by the U.S. Food and Drug Administration include acetylcholinesterase inhibitors and memantine. Nonpharmacologic interventions include cognitive training, lifestyle behavioral interventions, exercise, educational interventions, and multidisciplinary care interventions. Some interventions focus on the caregiver and aim to improve caregiver morbidity and delay institutionalization of persons with dementia.|
|Balance of Benefits and Harms||The evidence on screening for cognitive impairment is lacking, and the balance of benefits and harms cannot be determined.|
|Other Relevant USPSTF Recommendations||The USPSTF has made recommendations related to several of the risk factors for cognitive impairment, including counseling on tobacco cessation, alcohol use, healthful diet, physical activity, and falls prevention and screening for high cholesterol, hypertension, and depression. This recommendation is available at http://www.uspreventiveservicestaskforce.org/.|
For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.
Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Current as of March 2014
Internet Citation: Clinical Summary: Cognitive Impairment in Older Adults: Screening. U.S. Preventive Services Task Force. October 2014.