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May 7, 2010 | Comments: 1

Who Needs Alzheimer’s Testing?

Some experts think all older people should be tested for Alzheimer’s. Would you be better off if the disease could be diagnosed early, and if you and your relatives were tested?

Many community groups now offer tests for memory problems, looking for signs of early Alzheimer’s or other kinds of dementia. Some doctors already routinely test people over 65, usually with questionnaires (“name as many animals as you can think of in one minute,” and so on). There are also tests to help you diagnose yourself.

Universal screening for Alzheimer’s remains controversial, and for many good reasons:

• It would include many people with no memory problems at all. Apart from the waste of time and money, testing can lead to worry, depression, and family disruption.

• There’s no sure way to differentiate between mild age-related cognitive impairment, which may never get worse, and early Alzheimer’s. If the test tells you that you’re okay now but may develop dementia later, what can you do with that information?

• Diagnostic tests for early dementia are not reliable, especially in people under 70. Misdiagnoses could be devastating. People might lose their jobs, driver’s license, or even their potential caregivers, and be unable to get medical or life insurance.

• If early diagnosis leads to more treatment with medication, that’s a mixed bag. Alzheimer’s drugs are expensive, and their benefits are very limited and of short duration. They are prescribed only for people who are already exhibiting clear signs of dementia.

• Early diagnosis would benefit the drug companies more than the public, according to some critics.

Where we stand now

Alzheimer’s may be the diagnosis people dread most. The risk rises with age, and the numbers are increasing. We urgently need a clear understanding of this disease and better diagnostic tools. We need preventive measures, as well as effective treatments. Further research into Alzheimer’s testing is necessary before burdening patients and their already overtaxed primary-care physicians with screening tests of dubious reliability and unproven benefits.

Bottom line: If you fear that you or a family member may be showing signs of severe memory loss or Alzheimer’s, discuss the problem with your doctor. If testing reveals no problem, you’ll be relieved. If you do get a diagnosis of dementia, you can prepare for the future to the best of your ability and, if advised, try the medications that exist. We caution against tests at community centers and the like, or self-tests. 

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