Acceptance of dementia screening in continuous care retirement communities: a mailed survey.

BACKGROUND: In a recent systematic review of the evidence for dementia screening to support recommendations from the US Preventive Services Task Force, we found no evidence regarding the interest or willingness of older adults to be screened, and insufficient evidence to provide an estimate of the potential harms of dementia screening.
OBJECTIVE: In an attempt to address the acceptability of dementia screening, we asked older adults living in two Continuous Care Retirement Communities (CCRC) if they would agree to routine screening for memory problems.
DESIGN: Cross-sectional study using self-administered mailed survey questionnaires.
SETTING: Two CCRCs in Orange County, North Carolina. PARTICIPANTS: 500 residents of the independent living section of CCRCs.
RESULTS: There was a 64% survey response rate. Of these, 49% of participants stated they would agree to routine screening for memory problems. In comparison to people who would not agree to routine memory screening, those who accepted memory screening were more likely to accept depression screening, be male, use drug-administration assisted devices, and take more medications.
CONCLUSION: Approximately half of the residents in this affluent residential community setting were not willing to be screened routinely for memory problems. This high refusal rate indicates that dementia screening may be associated with perceived harms. We must improve our understanding of the decision-making process driving individual's beliefs and behaviors about dementia screening before implementing any broad-based screening initiatives for dementia or cognitive impairment. Copyright 2003 John Wiley & Sons, Ltd.