Alzheimer’s Society dismisses expert's claim dementia screening is ‘potentially harmful’

Academics from Australia and the UK have been criticised by Alzheimer’s Society after publishing claims that a move to a dementia screening process is ‘politically driven.’

Publishing their research in the British Medical Journal, a team of academics have claimed that screening older people for minor memory changes has no evidence of its benefits, can lead to incorrect diagnosis and even divert resources that are needed to care for people with advanced dementia.

The statements have been strongly opposed by Alzheimer’s Society, which has emphasised there are no plans to introduce the type of population screening to the UK criticised by the report, and any discussion of screening is not relevant.

Professor David Le Couteur from the University of Sydney, said: “Although evidence suggests that only five to 10 per cent of people with mild cognitive symptoms will develop dementia each year, current policy in many countries is aimed at encouraging more widespread and earlier diagnosis of dementia."

“In England, the Government has announced that it will reward general practitioners for assessing brain function in older patients - and has committed to have "a memory clinic in every town and every city" despite no sound evidence of benefit.

"For example, in the US, the Medicare insurance programme will cover an annual wellness visit to a physician that includes a cognitive impairment test.

"This has led to the development of imaging techniques and tests that are increasingly used in diagnosis, despite uncertainty over their accuracy.

"Furthermore, there are no drugs that prevent the progression of dementia or are effective in patients with mild cognitive impairment, raising concerns that once patients are labelled with disease or pre-disease, they may try untested therapies and run the risk of adverse effects."

Noting the desire from politicians, academics and clinicians to raise the profile of dementia, Professor Le Couteur said: “We risk being conscripted into an unwanted war against dementia."

Professor Couteur claimed the result of expanding dementia diagnosis will be up to 65 per cent of people over the age of 80 being diagnosed with Alzheimer’s and up to 23 per cent of older people being wrongly labelled as having dementia.

The academics also said it could be argued that the ageing population is becoming a ‘commercial opportunity’ for those who are developing screening, early diagnosis tests and creating medicines marketed to maintain cognition in old age.

Alzheimer’s Society believes getting a dementia diagnosis is vital for people so they can gain full access to care and support.

Jeremy Hughes, chief executive, Alzheimer’s Society said: “It’s astounding to hear talk of an ‘unwanted war’ on dementia when in fact we need nothing less than an all-out fight back.

“We should be backing doctors up and down the country who are helping ensure people with dementia are diagnosed.

Jeremy Hughes

“Discussion of screening is irrelevant as no one is advocating its introduction. There is surely no other condition where we could tolerate, let alone encourage, people being kept in the dark, without treatments or support and unable to make decisions about their life.”

He added: “The huge human cost of dementia is matched only by the spiralling cost to the economy of people with the condition who reach crisis point and need expensive hospital care. By 2021, a million people will have dementia. We cannot afford to bury our heads in the sand over the condition.”

Currently in the UK, clinicians ask people they feel are at a higher risk of developing dementia and refer them to appropriate tests if they are concerned.