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- Page navigation anchor for RE: Evidence based medicine and dementiaRE: Evidence based medicine and dementiaClaire Hilton describes how NHS policy in the current Dementia crusade could distort good clinical practice.1 I think the departure from evidence-based medicine is even greater than she suggests.Case finding for dementia was introduced when there was no evidence (beyond anecdotes) that it was beneficial. We have known for a decade that screening for memory loss identifies less than one in five of those who will subsequently develop dementia syndrome.2 We now have evidence that early psychosocial intervention has no effect on relocation to a care home, patient well-being, disease progression, dementia-related symptoms or caregiver well-being.3We have no evidence that memory clinics are the best way to reach diagnoses.4 and grounds for thinking that their resources might be better used to manage dementia’s behavioural and psychological symptoms.We do not know that earlier recognition and intervention is harmless4, and there seems little interest in finding out. We might be concerned that dementia now overshadows other problems of ageing, like depression and frailty.We do know that the incidence and prevalence of dementia syndrome appear to be declining in many countries, including Britain5 , Germany, Spain, Sweden, the Netherlands and the USA.6 This may mean t...Show MoreCompeting Interests: Member of the Alzheimer's Society; member of the NICE/SCIE Dementia clinical guidelines development group 2004-6; associate director of the national Dementias & Neurodegenerative Diseases Research Network (DENDRON) 2006-15; working group chair for the National Dementia Strategy 2009.