IU and Regenstrief conducting nation's first randomized controlled dementia screening trial

April 4, 2013

Researchers from the Indiana University Center for Aging Research and the Regenstrief Institute are conducting the nation's first randomized controlled dementia screening trial to weigh the benefits and risks of routine screening for dementia. The results of the five-year trial will help policy-makers, individuals and families weigh the pros and cons of routine screening of adults age 65 and older.

The Indiana University Trial: The IU Choice Study is enrolling 4,000 participants randomized into usual care or screening. Those who receive usual care will not be screened for dementia on a routine basis. Patients randomized to the screening track will receive dementia screening, and those whose screening results are positive for cognitive impairment will participate in the Healthy Aging Brain Care collaborative dementia care program. Patients from both study arms will be followed for at least 12 months.

"A fundamental tenet of any screening program is that it should reduce individual and societal burdens," said Regenstrief Institute investigator Malaz Boustani, M.D., MPH, the study's principal investigator. He is the associate director of the IU Center for Aging Research and an associate professor of medicine at the IU School of Medicine. He sees patients at the Wishard Healthy Center and is also an IU Health physician. "Until we have data we can't make the right decision on whether or not physicians should conduct routine dementia screening of individuals who have no symptoms of . IU Choice is the first step in the direction of acquiring that critical data."

In 2003, the U.S. Task Force reviewed existing evidence regarding dementia screening in primary care and reported it could not determine whether the benefits outweighed the harms.

According to Dr. Boustani, who was a lead author of the U.S. Preventive Services report, this lack of evidence persists a decade later. Yet since 2011, the Center for Medicare and Medicaid Services has reimbursed physicians for an annual wellness visit that includes detection of , he said.

"We need to know whether serves patients, families and society," said Dr. Boustani, who is a geriatrician and health services researcher. "Will routine dementia screening ensure better care and better health at a lower cost, or will it be a burden to the health care system with little benefit to older adults? Is early recognition of cognitive decline helpful? Should we wait until dementia becomes symptomatic, or should primary care doctors screen everyone?"

"We don't know enough to tell doctors to screen all their older patients for dementia. There is just not enough data to make the right decision on routine dementia screening. All these questions require answers before recommendations can be made."

Dr. Boustani and colleagues previously conducted a study on the stigma associated with dementia screening. Almost 90 percent of the 554 people in the study, who ranged in age from 65 to 96, indicated willingness by undergoing actual screening.

Routine screenings for conditions such as colon cancer have improved patient health and reduced societal burdens of diseases. However, screening may cause side effects, excessive costs and controversy, as in the case of prostate cancer screening.

Explore further: Study: Willingness to be screened for dementia varies by age but not by sex, race or income

Related Stories

Study: Willingness to be screened for dementia varies by age but not by sex, race or income

June 19, 2012
The first study to examine the actual willingness of older adults to be screened for dementia has found that acceptance of screening is pervasive, although it varies by age. However, willingness to be screened for dementia ...

Cognitive impairment in older adults often unrecognized in the primary care setting

February 13, 2012
A new study published in the Journal of the American Geriatrics Society reveals that brief cognitive screenings combined with offering further evaluation increased new diagnoses of cognitive impairment in older veterans two ...

First study of screening for cognitive impairment in hospitals

April 20, 2012
Neither screening for cognitive impairment nor screening followed by computerized alerts to the health care team improved patient outcome according to the first randomized, controlled study of care provided to hospitalized ...

Regenstrief extending successful aging brain care model globally

May 2, 2012
The resources developed for an innovative collaborative model of dementia care, which reduces emergency room and hospital visits and improves the quality of care for those with dementia, are now available to institutions, ...

Recommended for you

Noninvasive eye scan could detect key signs of Alzheimer's years before patients show symptoms

August 17, 2017
Cedars-Sinai neuroscience investigators have found that Alzheimer's disease affects the retina—the back of the eye—similarly to the way it affects the brain. The study also revealed that an investigational, noninvasive ...

Could olfactory loss point to Alzheimer's disease?

August 16, 2017
By the time you start losing your memory, it's almost too late. That's because the damage to your brain associated with Alzheimer's disease (AD) may already have been going on for as long as twenty years. Which is why there ...

New Machine Learning program shows promise for early Alzheimer's diagnosis

August 15, 2017
A new machine learning program developed by researchers at Case Western Reserve University appears to outperform other methods for diagnosing Alzheimer's disease before symptoms begin to interfere with every day living, initial ...

Brain scan study adds to evidence that lower brain serotonin levels are linked to dementia

August 14, 2017
In a study looking at brain scans of people with mild loss of thought and memory ability, Johns Hopkins researchers report evidence of lower levels of the serotonin transporter—a natural brain chemical that regulates mood, ...

Alzheimer's risk linked to energy shortage in brain's immune cells

August 14, 2017
People with specific mutations in the gene TREM2 are three times more likely to develop Alzheimer's disease than those who carry more common variants of the gene. But until now, scientists had no explanation for the link.

Scientists reveal role for lysosome transport in Alzheimer's disease progression

August 7, 2017
Researchers from Yale University School of Medicine have discovered that defects in the transport of lysosomes within neurons promote the buildup of protein aggregates in the brains of mice with Alzheimer's disease. The study, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.