Early Dementia Screening: First, Do No Harm

Essayists point out the dangers and logical weaknesses in the current drive to identify people with predementia.

As the population ages, we recognize the serious implications of the increasing number of individuals who will be diagnosed with Alzheimer disease (AD). Because AD may take years to become clinically manifest (NEJM JW Neurology Jul 31 2012), many researchers are attempting to develop strategies to detect it in the early stages or to delay or prevent it — whether lifestyle changes (NEJM JW Psychiatry May 16 2011) or new pharmacotherapies. Many have called for more “predementia” screening and for newer diagnostic modalities, from cerebrospinal-fluid markers to new ligands for positron emission tomography. Now, a new analysis asks us to consider the practical and ethical implications of these efforts.

The authors observe that the diagnosis of “…

Reviewing Author

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

Leadership Positions in Professional SocietiesNorth American Brain Injury Association (Board Member); National Institute on Disability, Independent Living, and Rehabilitation Research (Chair of Data Monitoring Safety Board for study of donepezil on cognition after traumatic brain injury)

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

Early Dementia Screening: First, Do No Harm

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Reviewing Author