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BMJ 2013;347:f4638 doi: 10.1136/bmj.f4638 (Published 19 July 2013) Page 1 of 1 News

BMJ 2013;347:f4638 doi: 10.1136/bmj.f4638 (Published 19 July 2013)

Page 1 of 1

News

NEWS

Systematic review finds no benefits to population screening for dementia

Nigel Hawkes

London

Screening the population for dementia offers no clinical benefits, a systematic review of the evidence has shown, while potential harms such as the risk of depression, anxiety, stigma or loss of independence remain unexamined in any study the researchers could find.

Carol Brayne, of the Cambridge Institute for Public Health, and the study’s lead author said, “Policy makers should be very cautious about adopting population screening for dementia without any evidence of benefit or risks.”

The study was presented this week at the Alzheimer’s Association International Conference in Boston.

Plans to screen for dementia have been proposed both by the Department of Health in the United Kingdom and by Medicare in the United States. The researchers examined all the studies they could find of screening either as a standalone policy or as part of dementia care, comparing outcomes with those of a routine pattern of care.

They said, “We found no evidence of the effect of screening on patient outcomes such as cognitive, mental or emotional health, social function or planning.” Six studies of the economic impact of screening were included: they found it was costly. The team found no studies on the possible harms.

The researchers said, “The pressure for faster diagnosis and for population screening is increasing despite the lack of effective

early treatment. Yet we found no evidence that, if rolled out, population screening would lead to better clinical or psychosocial outcomes, no evidence furthering our understanding of the risks it entails and no indication of its added value compared to current practice.”

The review, which has not yet been published, was jointly funded by the Alzheimer’s Society and the BUPA Foundation at a cost of £131 623 (€153 000; $200 000).

Brayne gave her support to a “rallying call”, published in the BMJ at the end of 2012, for an evidence based approach to dementia screening. It was signed by 17 specialists. 1 In a response, Alistair Burns, the National Clinical Director for Dementia in England, and others, denied that the proposals amounted to screening as usually understood, and that the government was looking for “timely” rather than “early” diagnosis of dementia. 2

1 Brunet MD, McCartney M, Heath I, Tomlinson J, Gordon P, Cosgrove J, et al. There is no evidence base for proposed dementia screening. BMJ 2012;345:e8588.

2 Burns A and colleagues. There is no evidence base for proposed dementia screening:

rapid response.www.bmj.com/content/345/bmj.e8588/rr/637358.

Cite this as: BMJ 2013;347:f4638

© BMJ Publishing Group Ltd 2013