Population	Community-dwelling adults who are older than age 65 years and have no signs or symptoms of cognitive impairment
Recommendation	No recommendation
	Grade: I statement
Risk assessment	Increasing age is the strongest known risk factor for cognitive impairment. Other reported risk factors for cognitive impairment include cardiovascular risk factors (such as diabetes, tobacco use, hypercholesterolemia, and hypertension), head trauma, learning disabilities (such as Down syndrome), depression, alcohol abuse, physical frailty, low education level, low social support, and having never been married.
Screening tests	Screening tests for cognitive impairment in the clinical setting generally include asking patients to perform a series of tasks that assess 1 or more cognitive domains (memory, attention, language, and visuospatial or executive functioning). The most widely studied instrument is the Mini-Mental State Examination.
	Other instruments with more limited evidence include the Clock Drawing Test, Mini-Cog, Memory Impairment Screen, Abbreviated Mental Test, Short Portable Mental Status Questionnaire, Free and Cued Selective Reminding Test, 7-Minute Screen, Telephone Interview for Cognitive Status, and Informant Questionnaire on Cognitive Decline in the Elderly.
Treatment	Pharmacologic treatments approved by the U.S. Food and Drug Administration include acetylcholinesterase inhibitors and memantine. Nonpharmacologic interventions include cognitive training, lifestyle behavioral interventions, exercise, educational interventions, and multidisciplinary care interventions. Some interventions focus on the caregiver and aim to improve caregiver morbidity and delay institutionalization of persons with dementia.
Balance of benefits and harms	The evidence on screening for cognitive impairment is lacking, and the balance of benefits and harms cannot be determined.
Other relevant USPSTF recommendations	The USPSTF has made recommendations related to several of the risk factors for cognitive impairment, including counseling on tobacco cessation, alcohol use, healthful diet, physical activity, and falls prevention and screening for high cholesterol, hypertension, and depression. These recommendations are available at http://www.uspreventiveservicestaskforce.org/.