The Alzheimer’s Association has said that they do not support one-time screening for Alzheimer’s disease. They estimate that as many as 50% of people with Alzheimer’s do not receive a formal diagnosis until after the dementia as significantly progressed. Therefore, they suggest setting up a baseline cognitive evaluation with regular follow-up assessments to help detect the disease as soon as possible. This way, tracking a cognitive decline over time would be detected far sooner than a one-time screening. In particular, they urge this practice of setting up a baseline with regular follow-ups to be part of the Medicare Annual Wellness Visit.
The Association defines a screening as a one-time procedure, typically the administration of a test that gives a numeric score. They have found that such a score does not accurately indicate the presence or absence of the disease. Rather, many times, these screenings yield numerous false positives and false negatives.
The Annals of Internal Medicine ran a study on Alzheimer’s screening services, and they came to the following conclusions:
- “We found no trials that directly assessed whether screening for cognitive impairment in primary care could affect decision-making, patient or caregiver, or societal outcomes.”
- “No studies directly addressed the adverse psychological effects of screening or adverse effects from false-positive or false-negative test results.”
- “We found no studies to substantiate or refute concerns about harms of screening.”
In other words, not enough of the right studies have been conducted in regards to screening and/or establishing cognitive baselines. What the journal really emphasizes is that the medical community needs “to develop better and simpler diagnostic tools, verify the NIA/Alzheimer’s Association new diagnostic criteria for Alzheimer’s disease, and confirm what experts are already saying–that early detection leads to better outcomes and reduced costs.”