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Towards evidence-based dementia screening in Australia

Zoe Terpening, John R Hodges and Nicholas J Cordato
Med J Aust 2011; 194 (2): . || doi: 10.5694/j.1326-5377.2011.tb04166.x
Published online: 17 January 2011

Effective dementia care depends on early and accurate diagnosis

It is predicted that over the next 40 years there will be a fourfold increase in the prevalence of dementia in Australia, as well as considerably more people with milder forms of cognitive impairment.1 To date, despite extensive research, no effective treatment for established dementia is available. As a result, taskforce policymakers conclude that there is insufficient evidence at present to warrant routine screening for dementia syndromes.2,3 However, emerging evidence shows that early non-pharmacological intervention can improve cognitive outcomes for patients with milder forms of cognitive impairment and those at risk of cognitive decline.4 Early diagnosis also enables patients to plan, with their caregivers, for the future, and deal with matters such as enduring power of attorney authorisation, before they lose the capacity to do so. Over two-thirds of people who notice symptoms of cognitive decline consult a physician for evaluation.5 However, up to 90% of mild cases are missed at the initial primary care assessment.6,7 So how can we improve early detection of cognitive impairment, and what evidence base do we have for dementia screening in Australia?


  • 1 Ageing Brain Centre, Brain and Mind Research Institute, University of Sydney, Sydney, NSW.
  • 2 Prince of Wales Medical Research Institute, Sydney, NSW.
  • 3 Department of Aged Care, St George Hospital and Calvary Rehabilitation and Geriatric Service, Calvary Health Care, Sydney, NSW.


Correspondence: zoe.terpening@sydney.edu.au

Competing interests:

Nicholas Cordato has received a grant from the Medical Foundation, University of Sydney, to research Alzheimer’s disease.

  • 1. Access Economics. Keeping dementia front of mind: incidence and prevalence 2009–2050. 2009. http://www.accesseconomics.com.au/publicationsreports/getreport.php?report=214&id=272 (accessed Nov 2010).
  • 2. United Kingdom National Screening Committee. Policy database. Alzheimer’s disease. http://www.screening.nhs.uk/alzheimers (accessed Dec 2010).
  • 3. Boustani M, Peterson B, Harris R, et al. Screening for dementia. June 2003. Agency for Healthcare Research and Quality, US Department of Health and Human Services. (AHRQ contract no. 290-97-0011.) http://www.ahrq.gov/downloads/pub/prevent/pdfser/dementser.pdf (accessed Dec 2010).
  • 4. Naismith S, Glozier N, Burke D, et al. Early intervention in cognitive decline: is there a role for multiple medical or behavioural interventions? Early Intervent Psychiatry 2009; 3: 19-27.
  • 5. Wilkinson D, Stave C, Keohane D, Vincenzino O. The role of general practitioners in the diagnosis and treatment of Alzheimer’s disease: a multinational survey. J Int Med Res 2004; 32: 149-159.
  • 6. Boustani M, Peterson B, Hanson L, et al. Screening for dementia in primary care: a summary of the evidence for the US Preventive Services Task Force. Ann Intern Med 2003; 138: 927-937.
  • 7. Valcour VG, Masaki KH, Curb JD, Blanchette PL. The detection of dementia in the primary care setting. Arch Intern Med 2000; 160: 2964-2968.
  • 8. Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc 1992; 40: 922-935.
  • 9. Zarit SH, Blazer D, Orrell M, Woods B. Throwing down the gauntlet: can we do better than the MMSE? Aging Ment Health 2008; 12: 411-412.
  • 10. Lonie JA, Tierney KM, Ebmeier KP. Screening for mild cognitive impairment: a systematic review. Int J Geriatr Psychiatry 2009; 24: 902-915.
  • 11. Terpening Z, Cordato N, Hepner I, et al. Utility of the Addenbrooke’s Cognitive Examination — Revised for the diagnosis of dementia syndromes. Australasian J Ageing 2010. doi: 10.1111/j.1741-6612.2010.00446.x [17/08/10]

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