Screening for Alzheimer’s and related dementias has minimal effect in older adults

Screening for Alzheimer’s disease and related dementias (ADRD) in older adults does not improve health-related quality of life (HRQoL), though it also does not seem to cause additional harm, a recent study has found.

Researchers conducted a single-blinded, two-arm, randomized controlled trial including 4,005 elderly patients (mean age, 74.1±6.9 years; 66 percent female) receiving primary care. Participants were assigned to receive either ADRD screening (n=2,008) or a control intervention (n=1,997). Screening was performed using the Memory Impairment Screen or the Mini-Cog tool.

HRQoL was comparable between groups after 12 months. Both the screening and control arms had a Health Utilities Index (HUI) score of 0.68 (effect size, 0.009, 95 percent confidence interval [CI], –0.063 to 0.080; p=0.81). Baseline scores were 0.67 in either group and were likewise statistically comparable.

HUI scores were similarly comparable at the 1-month (0.71 vs 0.69; mean difference, 0.014, 95 percent CI, –0.004 to 0.031; p=0.13) and 6-month (0.69 vs 0.70; mean difference, –0.003, 95 percent CI, –0.022 to 0.015; p=0.73) follow-ups between the screen and control groups.

This lack of clear benefit was matched by a lack of negative effects. Depressive symptoms, as measured by the Patient Health Questionnaire-9, were comparable between the screening and control arms at month 12 (mean scores: 2.74 vs 2.82; mean difference, –0.185, 95 percent CI, –0.393 to 0.025). The same null difference was reported at baseline, 1 month and 6 months.

Participants who were screened for ADRD likewise did not show elevated anxiety symptoms at 12 months, as by the Generalized Anxiety Disorder scale (screen vs control mean scores: 1.31 vs 1.45; mean difference, –0.164, 95 percent CI, –0.329 to 0.002).