Key points Since the public awareness and consultation rates of dementia are generally low in China, clinical conventional diagnosis and treatment cannot effectively address the problems of early detection, early diagnosis and early intervention for people at extreme risk of dementia. In order to provide community health service centers, health screening institutions and other primary health care institutions with appropriate cognitive impairment detection techniques and to establish effective follow-up and referral mechanisms, this consensus document was formed after in-depth discussions by relevant experts nationwide. This consensus includes the conditions of institutions and personnel related to memory checkups, examinees and their rights and interests, technical specifications and quality control of cognitive assessment, determination and reporting of results, health education countermeasures, follow-up and referral mechanism, etc. All institutions involved in memory health screening should conduct and report on this basis. Widespread and rational use of these testing techniques is the first step toward early diagnosis of dementia. A standardized memory examination to identify potential memory and cognitive problems and risk factors at an early stage and to assess the risk of dementia can effectively help some patients to take more proactive measures to reduce the chance of progression to more severe cognitive impairment and to obtain a better prognosis. Dementia is a clinical syndrome characterized by impairment of memory and cognitive functions, and Alzheimer’s disease (AD) is the most common cause, accounting for 60% to 80% of patients with dementia. The number of dementia patients in China is about 10 million, including about 6 million AD patients. Dementia is a major public health problem facing our aging society. Dementia, especially AD, is an irreversible and progressive disease. Only early detection, diagnosis and treatment can prevent and delay the occurrence and development of dementia and improve the quality of life of patients and families. Memory check is not only an important way to detect dementia early and reduce the rate of missed or delayed diagnosis and treatment of dementia patients, but also an indispensable prerequisite for early diagnosis and early treatment of dementia. Memory check or memory examination is a kind of cognitive function test different from physical examination for special groups (such as the elderly and those with cognitive-related risk factors), which has a unique form and professionalism. As early as the late 20th century, the United States and other developed countries have included memory checkups in the annual routine medical examination program for citizens. In China, it has not yet been included in the scope of medical examination. However, memory screening or dementia screening has gradually become a basic health need for the elderly in China. Screening can indeed identify early potential memory and cognitive problems and risk factors, assess the risk of dementia, propose early warning and health management plans, and can effectively help some patients to take more active measures to reduce the chance of developing more serious cognitive impairment and delay the onset of dementia. The target population and quality control of memory checkups 1. Elderly people over 65 years old need to undergo annual routine memory checkups. 2. For adults under 65 years of age, annual memory screening is recommended for those with one of the following risk factors: (1) Patients with symptomatic/asymptomatic cerebrovascular disease; (2) Patients with significant cerebral white matter abnormalities; (3) Patients with a history of traumatic brain injury; (4) Patients with cerebral artery stenosis; (5) Patients with Parkinson’s disease; (6) Patients with a history of coma, shock, seizures, etc.; (7) Patients with a history of carbon monoxide poisoning (7) Patients with a history of carbon monoxide poisoning; (8) Patients with addiction to sleeping pills; (9) Patients with a family history of dementia; (10) Patients with a combination of multiple risk factors such as hypertension, diabetes, hyperlipidemia, smoking, and alcohol abuse; (11) Patients with a combination of myocardial infarction, atrial fibrillation, and chronic cardiac insufficiency; (12) Patients after coronary artery bypass grafting; (13) Patients after general anesthesia; (14) Patients with hip fracture; (15) Patients with severe coronary artery bypass grafting (15) Patients with severe chronic obstructive pulmonary disease or sleep apnea syndrome; (16) Patients with hypothyroidism; (17) Patients with folic acid, vitamin B12 deficiency and hyperhomocysteinemia; (18) Patients with known positive serological tests for syphilis and HIV. (3) Those with complaints such as memory loss should have a memory examination every six months, regardless of whether they are under 65 years of age. For those who have the above risk factors but no complaints of memory loss, it is recommended to have a memory check every 1 year. 4. In the medical checkups for cadres, employees, retirees and community residents, we suggest adding memory checkups and encouraging voluntary memory checkups as part of the health assessment file. Quality control 1. In addition to special training, memory checkup personnel should also receive regular knowledge updates such as continuing medical education. 2. The examinee should be reminded to bring the necessary glasses, hearing aids and other correction devices during the examination to avoid affecting communication and examination results. 3. The attention and cooperation level of the examinees should be evaluated during the examination. 4. The examination process should assess the level of education, dialect and economic and cultural background of the subject, the level of functioning before the onset of the disease, personal achievement, language ability, as well as the possible impact of sensory deficits, mental illness, somatic/neurological diseases on the examination results, and must be recorded. 5.The examination room is functionally independent and quiet, without clocks, calendars and other suggestive objects or furnishings that affect the attention of the examinee. 6, the examiner should pay attention to the applicability of different testing tools to highly knowledgeable, highly intelligent people or low education, illiterate. 3. Ethics and privacy protection 1. Adhere to the principle that the subject voluntarily chooses the memory test and does not force the test. 2.The examiner should be courteous and respectful to the examinees to ensure that their dignity is not violated. 3.Ensure that the subject or the informant is aware of the meaning and content of the test performed. 4.The examiner is obliged to inform the examinee of the possible benefits of the test, or the anxiety and anxiety it may cause, and the possible effects on work, family, children, and life. 5.Before the assessment, the examinee needs to be asked whether he/she wants to know the result of the test (high risk of dementia), whether he/she wants to perceive this result to others and who it is. The test subject or family should be informed how to obtain the results of this test. 6. If the examinee wants to keep the results of the examination confidential, it should be recorded. Memory check items and instructions guidance I. Memory check scale selection principles scientific: should choose the neuropsychological scales and tools that have been widely used and have established Chinese normative. Validity: The scales and tools with high sensitivity and specificity should be selected, and the combination of self-assessment and other assessment scales is recommended. Practical: Preferred scales should be simple and easy to administer, short in time, universal, suitable for non-medical practitioners, and acceptable to primary care institutions and medical examination institutions. Grading: Each memory clinic can choose the appropriate scale to carry out practical work according to its own staff and working conditions. Recommended neuropsychological scales (a) Cognitive function assessment Commonly used tools: AD8 and IQCODE for informed persons; mini-Cog, MMSE, MoCA, MES for patient assessment. The Mental Status Examination (MMSE), the Montreal Cognitive Assessment Scale (MoCA), and the Memory and Executive Screen (MES). Neuropsychological tests that measure different cognitive domains are available for those who are able to use them. (ii) Assessment of activities of daily living and social functioning 1) ADL scale 2) Caring burden scale (ZBI) (iii) Assessment of psychiatric symptoms 1) Neuropsychiatric symptoms questionnaire (NPI) 2) Geriatric depression scale (GDS) Memory screening is recommended. It is advisable to have a family member or a knowledgeable person accompany the examination, and the results of the memory examination should only be used as a diagnostic reference, not as a conclusion. Secondly, it is important to explain to the subject the importance of early detection of memory disorders, early diagnosis and intervention, with the aim of disease prevention and crisis management. Third, it is important to make the examinees understand that there are certain boundaries to the accuracy of the memory physical examination. There is no single tool that can be used as a gold standard for assessing cognitive impairment, much less a definitive or exclusionary impairment with 1 screening. Fourth, progressive cognitive decline is critical evidence for the diagnosis of AD and other progressive cognitive impairment disorders. Therefore, follow-up observation and periodic assessment of older adults with memory loss is of great importance. Contents of the memory checkup report form 1. Basic information of the subject 2. Who will be entrusted to receive the results of this examination and their contact information, and whether the results are confidential. 3.The content, score, normal value range and result determination of the examination items and sub-items. 4.The degree of participation of the examinees during the examination (good, moderate, poor) and the reliability of the results (reliable, fair, unreliable). 5.Recommendations for follow-up treatment such as referral and follow-up. 6.Provide management methods and guidance on relevant risk factors according to the examination results. 7.Report date and signature of the examiner. Recommend the establishment of a referral mechanism between the neurology, psychiatry, and encephalopathy outpatient clinics or memory centers of hospitals with conditions, community health service centers, and medical checkup institutions. To refer patients to medical institutions specializing in cognitive disorders in a targeted manner. 2. The principle of patient’s voluntariness 3. The principle of continuous management 2. Referral system (a) Neurology, psychiatry, encephalopathy outpatient clinic or memory center responsibilities (b) Community health service center responsibilities 3. 2.Persons with memory impairment with cognitive impairment found in the initial screening. 3.Patients with complaints of memory loss that have persisted for more than 6 months or rapid progression/deterioration of cognitive function in the last 6 months. Community health service centers who are found to have one of the above conditions may be referred exclusively to the specialist outpatient clinic or memory center of a tertiary care hospital for consultation.