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Screening for cognitive impairment in older adults: A systematic review for the U.S. Preventive Services Task Force
Lin JS, O'Connor E, Rossom RC, Perdue LA, Eckstrom E.. Annals of internal medicine, 2013-11-01
Topic: Risk, prevention and care in population studies
Background Earlier identification of cognitive impairment may reduce patient and caregiver morbidity. Purpose To systematically review the diagnostic accuracy of brief cognitive screening instruments and the benefits and harms of pharmacologic and nonpharmacologic interventions for early cognitive impairment. Data sources MEDLINE, PsycINFO, and the Cochrane Central Register of Controlled Trials through December 2012; systematic reviews; clinical trial registries; and experts. Study selection English-language studies of fair to good quality, primary care–feasible screening instruments, and treatments aimed at persons with mild cognitive impairment or mild to moderate dementia. Data extraction Dual quality assessment and abstraction of relevant study details. Data synthesis The Mini-Mental State Examination (k = 25) is the most thoroughly studied instrument but is not available for use without cost. Publicly available instruments with adequate test performance to detect dementia include the Clock Drawing Test (k = 7), Mini-Cog (k = 4), Memory Impairment Screen (k = 5), Abbreviated Mental Test (k = 4), Short Portable Mental Status Questionnaire (k = 4), Free and Cued Selective Reminding Test (k = 2), 7-Minute Screen (k = 2), and Informant Questionnaire on Cognitive Decline in the Elderly (k = 5). Medications approved by the U.S. Food and Drug Administration for Alzheimer disease (k = 58) and caregiver interventions (k = 59) show a small benefit of uncertain clinical importance for patients and their caregivers. Small benefits are also limited by common adverse effects of acetylcholinesterase inhibitors and limited availability of complex caregiver interventions. Although promising, cognitive stimulation (k = 6) and exercise (k = 10) have limited evidence to support their use in persons with mild to moderate dementia or mild cognitive impairment. Limitation Limited studies in persons with dementia other than Alzheimer disease and sparse reporting of important health outcomes. Conclusion Brief instruments to screen for cognitive impairment can adequately detect dementia, but there is no empirical evidence that screening improves decision making. Whether interventions for patients or their caregivers have a clinically significant effect in persons with earlier detected cognitive impairment is still unclear. Primary funding source Agency for Healthcare Research and Quality.
Key findings
- Whether interventions for patients or their caregivers have a clinically significant effect in persons with earlier detected cognitive impairment is still unclear.
Why it matters
This systematic review for the U.S. Preventive Services Task Force found that several brief cognitive screening instruments have adequate test performance to detect dementia. It concluded that whether interventions for patients or their caregivers have a clinically significant effect in persons with earlier detected cognitive impairment is still unclear.
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Study details
- Evidence strengthLow
How this study scored 62/100
Published in a leading specialty journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of internal medicine) |
| Journal's citation record | 4 / 4 | Annals of Internal Medicine: journal h-index 648 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question (from PubMed type “Systematic Review”) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2013 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 6 / 7 | Cited 410 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 27.3 citations a year over 15 year(s) since 2013 |
| Impact for its field and year | 3 / 6 | Cited 6.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 12 other studies in this library |
| Still being cited | 3 / 4 | Cited 50 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Elizabeth Eckstrom: h-index 34 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Oregon Health & Science University: institution h-index 1,025 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 24145578) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 62 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Lin, J. S., O'Connor, E., Rossom, R. C., Perdue, L. A., & Eckstrom, E. (2013). Screening for cognitive impairment in older adults: A systematic review for the U.S. Preventive Services Task Force. Annals of internal medicine. https://doi.org/10.7326/0003-4819-159-9-201311050-00730
Vancouver
Lin JS, O'Connor E, Rossom RC, Perdue LA, Eckstrom E. Screening for cognitive impairment in older adults: A systematic review for the U.S. Preventive Services Task Force. Annals of internal medicine. 2013. doi:10.7326/0003-4819-159-9-201311050-00730. PMID: 24145578.
BibTeX
@article{lin2013-24145578,
author = {Lin, J. S. and O'Connor, E. and Rossom, R. C. and Perdue, L. A. and Eckstrom, E.},
title = {{Screening for cognitive impairment in older adults: A systematic review for the U.S. Preventive Services Task Force}},
journal = {Annals of internal medicine},
year = {2013},
doi = {10.7326/0003-4819-159-9-201311050-00730},
pmid = {24145578},
url = {https://doi.org/10.7326/0003-4819-159-9-201311050-00730}
}
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