In its recent recommendation on screening for cognitive impairment in older adults, the US Preventive Services Task Force (USPSTF) concludes that “the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment in older adults (I statement).”1 This conclusion, supported by an updated evidence report and systematic review,2 is the same one the task force reached in 2014 after similar extensive scrutiny of the evidence base.3 There continues to be insufficient evidence with which to evaluate the benefits and harms of systematic cognitive testing in asymptomatic people 65 years and older. Given the burden of dementia and the intense public interest in preventing cognitive impairment, the lack of progress is disheartening.