Routine Cognitive Screening Can Help Detect Early Signs of Dementia

Nora Super and Diane Ty, who lead the Milken Institute's Alliance to Improve Dementia Care, argue in STAT News that screening for cognitive impairment should be a standard procedure in the annual check-up for adults 65 and older. "We want older adults and their families to expect cognitive screening in the same way they understand the need for other screening tests for individuals without symptoms, such as annual mammograms or colonoscopy starting at age 45," they write. Super and Ty note that changes to the brain can start one to two decades before the manifestation of signs and symptoms of cognitive impairment. "This makes it essential to capture a baseline of brain health well in advance so it's possible to note changes over time," they stress. The authors cite a study from the Alliance to Improve Dementia Care, detailing the changes needed to prepare the healthcare workforce to effect the screening protocol. The report recommends that clinical workflows for primary care teams employ widely recognized training content and toolkits. Medicare also should require clinicians to use a structured cognitive screening tool during the yearly wellness visit rather than responses to questions or patients' self-reported concerns about memory.