Observations Open letter to the prime minister and chief medical officer for England

There is no evidence base for proposed dementia screening

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e8588 (Published 27 December 2012) Cite this as: BMJ 2012;345:e8588

Re: There is no evidence base for proposed dementia screening

If anything, shouldn't we be screening patients for Mild Cognitive Impairment (MCI) rather than dementia?

There is some evidence that, at least in patients with MCI and raised blood levels of homocysteine, high dose oral B-vitamins slow brain atrophy and improve both clinical and cognitive outcomes (1,2).

1) AD Smith et al Plos One 2010;5(9):e1244 "Homocysteine-Lowering by B Vitamins Slows the Rate of Accelerated Brain Atrophy in Mild Cognitive Impairment: A Randomized Controlled Trial"

2) de Jager et al Int.J.Ger.Psych 2012;27(6):592-600 "Cognitive and clinical outcomes of homocysteine-lowering B-vitamin treatment in mild cognitive impairment: a randomized controlled trial."

Competing interests: I am a scientific advisor and shareholder of Cobalz Limited - a private limited company developing novel B vitamin and antioxidant supplements.

15 January 2013
Andrew McCaddon
General Practitioner
Cardiff University
Gardden Road Surgery, Wrexham, LL14 2EN