Alzheimer’s disease, dementias chronically undiagnosed yet early detection rarely used

Despite the potential benefits of early detection and increasing treatment options for Alzheimer’s disease and related dementias, there is limited use of valuable screening and testing tools, say researchers at the University of Michigan.

Researchers at the U-M School of Public Health and Michigan Medicine studied responses from nearly 1,300 participants in the National Poll on Healthy Aging—a large, nationally representative survey of older adults—to understand experiences and views of cognitive screening and blood biomarker testing among adults aged 65-80.

Consistent with previous research, their study found that only about 1 in 5 older Americans reported having cognitive screening in the past year, with such rates lower among certain racial and ethnic minority groups (i.e., Hispanic, Asian American). More than 6.5 million people in the United States have Alzheimer’s disease or a related dementia, a number projected to double by 2060, according to the Alzheimer’s Association.

Published in Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, the study showed that a majority of older Americans are aware of the upsides of early detection— earlier treatment, financial planning and more.

Even with recognition of potential benefits and Medicare coverage of cognitive testing for beneficiaries, the underuse of cognitive screening persists, the researchers say. Millions of dementia cases go undiagnosed and untreated, fueled by multiple barriers to diagnosis at the patient, provider and health care system levels, which the study details.

“Living with Alzheimer’s disease or other dementias can impact entire families and social systems. When addressed early, individuals along with their loved ones and health care providers can work together to make important medical, financial and legal decisions for the future,” said Chelsea Cox, M.P.H., M.S.W., a doctoral student in the Department of Health Behavior and Health Equity at U-M’s School of Public Health.

The sooner a conversation about cognitive health occurs, the more possibilities for prevention, symptom control and treatment open up, said Scott Roberts, Ph.D., U-M professor of health behavior and health equity and a longtime Alzheimer’s disease and dementia researcher.
“Treatments are now available to help slow the course of Alzheimer’s disease, if started early enough, and there are promising clinical trials and risk reduction strategies available,” he said. “So for many older adults, talking to your doctor about your cognitive health can be as important as talking to your doctor about your physical health.”

Roberts is a member of the executive committee at the Michigan Alzheimer’s Disease Center and associate director of the National Poll on Healthy Aging, which is based at the U-M Institute for Healthcare Policy and Innovation. The poll team previously published a report on dementia screening and testing awareness and attitudes among adults aged 50 to 80; the new study focuses on those aged 65 to 80.

Study: Older US adults’ experiences with and views about cognitive screening and blood biomarker testing for Alzheimer’s disease (DOI: 10.1002/dad2.70067)

Prior related study: Determinants of dementia diagnosis in U.S. primary care in the past decade: A scoping review (DOI: 10.1016/j.tjpad.2024.100035)