BACKGROUND:In ambulatory care settings, patients with limited English proficiency receive lower quality of care. Limited information is available describing outcomes for inpatients.

• Practitioners should consider cognitive assessment for patients with signs and symptoms of impairment or when family members or patients express concerns about potential cognitive decline. cognitive impairment (scores of 10-17) and severe impairment (scores less than 10). Key points 13The ADAS-cog is a cognitive testing instrument not normally used in practice but often used in research studies. It consists of 11 tasks measuring disturbances of memory, language, praxis (i.e., application or use of specific knowledge or skills such as drawing geometric figures or fitting a page into an envelope), attention and other cognitive abilities. 9 A change in the ADAS-cog score of 4 points is considered by many clinical experts to represent a clinically important change. The MMSE and the MoCA tools are commonly used by Canadian clinicians in clinical practice.14 Treatments include medications such as cholinesterase inhibitors (i.e., donepezil, rivastigmine and galantamine), dietary supplements and vitamins, and nonpharmacologic interventions such as exercise, and cognitive training and rehabilitation. 10 Provincial payment for the medications used in primary care practice is often linked to cognitive assessment scores measured by the screening instruments.The objective of this guideline, which updates the 2001 Canadian Task Force on Preventive Health Care recommendations, 15 is to provide evidence-based recommendations on screening for cognitive impairment in adults. The guideline focuses on screening asymptomatic adults. This recommendation does not apply to men and women who are concerned about their own cognitive performance (i.e., patients who report cognitive changes to their clinician or others) or who are suspected of having mild cognitive impairment or dementia by clinicians or nonclinicians (i.e., caregivers, family or friends) and who have symptoms suggestive of mild cognitive impairment or dementia (e.g., loss of memory, language, attention, visuospatial or executive functioning, or behavioural or psychological symptoms that may mildly or substantially affect a patient's day-to-day life or usual activities). MethodsThe Canadian Task Force on Preventive Health Care is an independent panel of volunteer clinicians and methodologists that makes recommendations about clinical manoeuvres aimed at primary and secondary prevention (www.canadian taskforce.ca). The development of these recommendations was led by a workgroup of eight members of the task force and scientific staff at the Public Health Agency of Canada. The task force established this topic as a priority based on the potential to decrease inconsistencies in screening in primary care practice and a need to determine whether benefits of screening outweigh harms.The US Preventive Services Task Force recently published a systematic review on screening and treatment for cognitive impairment.11 Initially, the Canadian task force updated the US task force review, assessing the effects of screening for cognitive impairment on health outcomes. 9 The Evidence Revie...