Evidence to back dementia screening is still lacking, committee says

This report has just been published in the BMJ:

It has attracted this response from a “free spirit” and “old man”:

The article begins:

“GPs have again raised the question of why NHS England persists in promoting dementia ‘case finding’ after the UK advisory body on screening reiterated its view that the current test for dementia was not accurate enough to recommend it for routine use.”

My view, having studied the subject of “case-finding” is that it is one-and-the-same as screening:

Dr Martin Brunet stated in this BMJ article: “Unfortunately, despite the fact that there has never been a recommendation to screen for dementia, NHS England policy has been to introduce screening programmes in primary and secondary care by using the term ‘case finding,’ to circumvent [National Screening Committee] guidance.”

The article continues: “After reviewing the evidence on screening people aged over 65 for dementia, the UK National Screening Committee concluded that none of the tests currently used in practice distinguished well enough between people with dementia and those without.”

I have just had the following submission accepted for publication by the BMJ:

Dr Margaret McCartney stated in this BMJ article: “I hope that the architects of screening for dementia in the UK take heed of this reiteration that screening for dementia is ineffective and harmful. Who will be held to account for the harm that the dementia screening policy has done?”

Scotland’s approach to dementia diagnosis can be read here.

This film covers the evidence that Scotland gave to the All party Parliamentary Group in Westminster. The meeting was entitled “How to improve dementia diagnosis rates in the UK”

The article confirms the potentially high rate of false-positives: “The committee said that current tests showed that between seven and 17 in every 100 people over the age of 65 had mild cognitive impairment but that each year only about 5-10% of these would develop dementia. With use of current tests, 18 in 100 people would test positive for dementia, the committee said, but only six would actually have dementia, leaving 12 receiving a positive result when they didn’t have dementia, while one other person who did have dementia would be missed and be falsely reassured.”

I have long argued these concerns:

The parabolic pattern can be read here.