Re: There is no evidence base for proposed dementia screening
While the cost and possible harm to the patient of current drugs may compromise a dementia screening programme, the potential benefits of dietary modification should be considered. Several well-conducted prospective trials have found that in elderly populations in the US, adherence to a Mediterranean diet is associated with an improvement in cognitive function, with a reduction in the development of mild cognitive impairment (MCI) and with a reduction in the development of Alzheimer's disease, when compared with populations with low baseline adherence to this dietary pattern. Patients with MCI with moderate and high adherence to a Mediterranean diet had an impressive 45% and 48% respectively less risk of going on to develop Alzheimer's disease than patients in the lowest tertile of adherence. Unlike drug-based approaches for dementia prevention, a programme of advice and support to follow a Mediterranean diet represents a low cost, no harm strategy that would help underpin and justify the implementation of an early screening programme for dementia. In the broader view, we believe that the lack of emphasis and investment in primary and community services to support dietary and lifestyle changes that can demonstrably improve disease outcomes represents a weakness in current approaches to the management of long term conditions.