Screening for dementia or early cognitive impairment is of paramount importance. However, it should not be limited to patients in their seventies but should be done even for patients in their nineties. Otherwise we are going to create a biased service. We have to understand that screening for dementia will help with further investigations and treatment of reversible causes of this illness. Reference Boustani, Peterson, Harris, Lux, Krasnow and Sutton1
Another important issue would be that of mild cognitive impairment which, although not formally classified, has received due attention as interventions at this stage will certainly delay the expression of clinical symptoms. Reference Callahan, Hendrie and Tierney2 The National Dementia Strategy 3 is indeed a step in a right direction. With huge infusion of funds across England and Wales as well as establishing early diagnosis and intervention clinics, it is of paramount importance in identifying probable mild cognitive impairment early on by utilising various screening tests including blood test, scans and battery of neuropsychological testing. This will certainly help both patients and carers to be well prepared and informed, and reduces the risk of early institutionalisation.
Therefore, to say that patients in their nineties do not deserve full investigation is rather a Stone Age statement. Screening tests should be available to everyone regardless.
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