Political drive to screen for pre-dementia: not evidence based and ignores the harms of diagnosis

The use of biomarkers for the etiologic diagnosis of MCI in Europe: An EADC survey

“…Moreover, it should be acknowledged a potential site bias: it cannot be excluded that the 37 responder centers are those more enthusiastic on biomarkers, more active users, more interested and therefore more likely to respond to a survey about these markers than non-responder centers. However, given the current hot debate on early diagnosis and the polarization of the field into opposing ideological positions [44], a selection bias in favor of sites strongly against biomarkers cannot be ruled out. In addition, it should be noticed that EADC centers have been actively involved for more than 10 years in clinical and/or preclinical dementia research and clinical trials.…”

Raising the standard of applied dementia care research: addressing the implementation error

“…This is an urgent issue for psychosocial intervention research in dementia care as today 35.6 million people and families worldwide live with dementia , whilst major pharmaceutical advances in prevention and cure remain elusive (Miller, 2012). The predicted future growth of dementia cases over the next decade will undoubtedly raise the already high costs of care, estimated at US$ 604 billion in 2010 , in an illness that is most feared people over the age of 55 years (Le Couteur, Doust, Creasey, & Brayne, 2013), since it can undermine core human capacities resulting in decline in quality of life (Selkoe, 2012). Although cure for dementia is not available for dementia patients, we are not empty handed.…”

Clinical history for diagnosis of dementia in men: Caerphilly Prospective Study

“…Avoiding overdiagnosis (high specificity) may be more important than finding all possible cases (high sensitivity), as currently there are no drugs that modify the natural history of dementia 41 and there are potential disadvantages from overdiagnosis. 1,11,42 In this study, simple questions had high post-test probability of unspecified dementia. In principle, this raises the possibility that GPs who are considering dementia after evaluating a person with symptoms might be able to make the diagnosis, without specialist input, using relatively simple adjunct questions.…”

“…Casefinding seeks to identify people with possible dementia who have not been formally diagnosed, and has been a source of particular debate. [1][2][3][4] In contrast, a formal diagnosis aims to be as definitive as possible about the presence or absence of dementia, but the process of getting a diagnosis is often not patient-centred. 5 In the general population there are often multiple contributing pathologies to dementia syndrome, 6,7 with the association between Alzheimer's pathology and dementia weakening with age.…”