Should Older Adults Be Screened for Cognitive Impairment?

Soo Borson, MD


Medscape General Medicine. 2004;6(1):e48 

In This Article

Underdetection of Dementia in Primary Care Practice

The great majority, perhaps upwards of 80%, of all medical care for dementia occurs in primary care settings, including doctors' offices, hospitals, and nursing homes; specialists initiate treatment for dementia in only about 15% of cases.[3] Among elderly outpatients, many cases go undiagnosed and, among patients whose dementia is recognized, fewer than one quarter are treated; overall, only about 10% to 15% of all patients receive an acetylcholinesterase inhibitor.[4] General practitioners consider detection of dementia desirable, but few screen patients unless impairment is already apparent. Waiting for symptoms of dementia to become obvious delays the diagnosis, often by several years, leading to delays in initiation of therapeutic interventions.