{"id":15479,"date":"2013-09-10T11:05:21","date_gmt":"2013-09-10T15:05:21","guid":{"rendered":"http:\/\/therapytoronto.ca\/news\/?p=15479"},"modified":"2013-09-11T01:33:22","modified_gmt":"2013-09-11T05:33:22","slug":"screening-for-minor-memory-changes-will-wrongly-label-many-with-dementia-warn-experts","status":"publish","type":"post","link":"https:\/\/therapytoronto.ca\/news\/2013\/09\/screening-for-minor-memory-changes-will-wrongly-label-many-with-dementia-warn-experts\/","title":{"rendered":"Screening for minor memory changes will wrongly label many with dementia, warn experts"},"content":{"rendered":"<p>From the BMJ-British Medical Journal media release:<\/p>\n<blockquote><p><a href=\"http:\/\/therapytoronto.ca\/news\/wp-content\/uploads\/2013\/07\/senior-care.jpg\"><img loading=\"lazy\" class=\"alignright size-full wp-image-14667\" alt=\"senior care\" src=\"http:\/\/therapytoronto.ca\/news\/wp-content\/uploads\/2013\/07\/senior-care.jpg\" width=\"216\" height=\"300\" \/><\/a>A political drive, led by the UK and US, to screen older people for minor memory changes (often called mild cognitive impairment or pre-dementia) is <strong>leading to unnecessary investigation and potentially harmful treatment for what is arguably an inevitable consequence of ageing<\/strong>, warn experts.<\/p>\n<p>Their views come as the <strong>Preventing Overdiagnosis conference<\/strong> opens in New Hampshire, USA today (10 September), partnered by <em>BMJ<\/em>&#8216;s Too Much Medicine campaign, where experts from around the world will gather to discuss how to tackle the threat to health and the waste of money caused by unnecessary care.<\/p>\n<p>A team of specialists in Australia and the UK say that <strong>expanding diagnosis of dementia will result in up to 65% of people aged over 80 having Alzheimer&#8217;s disease diagnosed &#8212; and up to 23% of non-demented older people being labelled with dementia.<\/strong><\/p>\n<p>They argue this policy is <strong>not backed by evidence and ignores the risks, harms and costs to individuals, families and societies<\/strong>. It may also divert resources that are badly needed for the care of people with advanced dementia.<\/p>\n<p>Dementia is age related and with an ageing population is predicted to become an overwhelming and costly problem. But the evidence suggests that while 5 &#8212; 15% of people with mild cognitive impairment will progress to dementia each year, <strong>as many as 40 -70% will not progress and indeed their cognitive function may improve<\/strong>.<\/p>\n<p>Studies also show that the clinical tools used by doctors to diagnose dementia are not robust, and <strong>that many people who develop dementia do not meet definitions of mild cognitive impairment before diagnosis<\/strong>. But this has not deterred countries from developing policies to screen for pre -dementia.<\/p>\n<p>For example, <strong>in the US, the Medicare insurance programme will cover an annual wellness visit to a physician that includes a cognitive impairment test<\/strong>. In England, the government has announced that it will reward general practitioners for assessing brain function in older patients &#8212; and has committed to have &#8220;a memory clinic in every town and every city&#8221; despite no sound evidence of benefit.<\/p>\n<p>This had led to the development of <strong>imaging techniques and tests that are increasingly used in diagnosis, despite uncertainty over their accuracy<\/strong>, say the authors. The researchers say however, that until such approaches are shown to be beneficial to individuals and societies they should remain within the clinical research domain.<\/p>\n<p>Furthermore, there are no drugs that prevent the progression of dementia or are effective in patients with mild cognitive impairment, raising concerns that once patients are labelled with disease or pre-disease, they may try untested therapies and run the risk of adverse effects.<\/p>\n<p><strong>They also question whether ageing of the population is becoming a &#8220;commercial opportunity&#8221; for developing screening<\/strong>, early diagnosis tests and medicines marketed to maintain cognition in old age.<\/p>\n<p>The desire of politicians, dementia organisations, and academics and clinicians in the field to raise the profile of dementia is understandable, write the authors, &#8220;but we risk being conscripted into an unwanted war against dementia.&#8221;<\/p>\n<p>They suggest that <strong>the political rhetoric expended on preventing the burden of dementia would be much better served by efforts to reduce smoking and obesity<\/strong>, given current knowledge linking mid-life obesity and cigarettes with the risk of dementia.<\/p>\n<p>&#8220;Current policy is rolling out untested and uncontrolled experiments in the frailest people in society without a rigorous evaluation of its benefits and harms to individuals, families, service settings, and professionals,&#8221; they conclude.<\/p><\/blockquote>\n<!-- AddThis Advanced Settings generic via filter on the_content --><!-- AddThis Share Buttons generic via filter on the_content -->","protected":false},"excerpt":{"rendered":"<p>From the BMJ-British Medical Journal media release: A political drive, led by the UK and US, to screen older people for minor memory changes (often called mild cognitive impairment or&#8230; <a class=\"read-more-link\" href=\"https:\/\/therapytoronto.ca\/news\/2013\/09\/screening-for-minor-memory-changes-will-wrongly-label-many-with-dementia-warn-experts\/\">Read more &raquo;<\/a><!-- AddThis Advanced Settings generic via filter on get_the_excerpt --><!-- AddThis Share Buttons generic via filter on get_the_excerpt --><\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[321,10,95,4],"tags":[],"_links":{"self":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts\/15479"}],"collection":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/comments?post=15479"}],"version-history":[{"count":5,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts\/15479\/revisions"}],"predecessor-version":[{"id":15499,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/posts\/15479\/revisions\/15499"}],"wp:attachment":[{"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/media?parent=15479"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/categories?post=15479"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/therapytoronto.ca\/news\/wp-json\/wp\/v2\/tags?post=15479"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}