The belief that there is value in screening for ‘pre-dementia’ or mild cognitive impairment is creeping into clinical practice, with the resulting over diagnosis having potential adverse consequences for individual patients, resource allocation, and research,” experts write in BMJ.
One problem, the authors say, is that pre-dementia does not necessarily predict future disease.
They cite evidence showing that only 5% to 10% of those with mild cognitive impairment will develop dementia in a given year, while up to 70% do not progress or may even see their cognition improve.
They point out that once diagnosed, patients might try therapies that are marketed for dementia, even though no drugs are proven effective. And many of these treatments come with side effects; for example, cholinesterase inhibitors increase risk for hip fracture.
In NEJM Journal Watch, Jonathan Silver comments: “Although development of early indicators of Alzheimer disease is a necessary endeavor, these research tests should not be routinely used in – Read more
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