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Should You Be Screened for Alzheimer’s?

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June 13, 2003

Recently published guidelines from the U.S. Preventive Services Task Force, a panel of experts that reviews the scientific evidence and advises the government on preventive health issues, concluded that there is not yet enough evidence to recommend that doctors routinely test all their patients for early signs of Alzheimer’s disease and other forms of dementia . However, if you, family members, or caretakers are concerned about any memory problems, including memory loss or confusion, you should let your doctor know, because testing may be helpful, the panel advised. The recommendations were based on research published in the June 3, 2003 issue of the Annals of Internal Medicine, a respected medical journal.

Diagnosing Alzheimer’s can be difficult, because there are no surefire tests to detect the illness, particularly in the earliest stages, when problems with remembering and thinking may be very mild. The most common type of memory testing done in a doctor’s office is the Mini-Mental State Examination, or MMSE. The MMSE consists of a brief questionnaire–several dozen questions–to assess the person’s ability to recall specific facts and dates and awareness.

In some cases, testing may suggest that a person has Alzheimer’s, when in reality they do not (“false-positive” results). In other cases, the tester may “miss” the diagnosis in a person who actually does have early Alzheimer’s because he or she answered enough questions appropriately (“false-negative” results). If a person has difficulty on the MMSE or another “quick test,” doctors will perform more rigorous memory tests.

The task force found that quick tests such as the MMSE are helpful for screening for dementia. However, only about half of people who test “positive” on these brief tests are found to actually have dementia on more rigorous testing. Accuracy depended in part on a person’s age and educational level. “False-positive” results were more common in older people with lower formal educational levels. “False-negative” results, on the other hand, were more common in younger individuals with more schooling.

Alzheimer’s Drugs, Other Findings

Early recognition of Alzheimer’s is important, because it can help patients and their doctors better manage the course of therapy. Patients can, for example, participate in taking Alzheimer’s drugs that may slightly slow the progression of the disease. Early diagnosis also helps family members and other caregivers anticipate and plan for future challenges in caring for the person with Alzheimer’s.

The task force review of the latest evidence also reported some additional findings.

By Toby Bilanow, Medical Writer, for www.ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Samuel E. Gandy, M.D., Ph.D., Chairman of the Scientific Advisory Board, Fisher Center for Alzheimer’s Research Foundation.

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