Is An Alzheimer’s Blood Test Right for Me?

During a recent call, Claire’s mom asked about “this new Alzheimer’s test” — a blood test that can detect abnormal levels of beta-amyloid, a protein linked to Alzheimer’s disease. For about $400, people can order the test and get their results on an app, bypassing the doctor’s office.

Though many people wonder about their Alzheimer’s risk, others prefer not to know. This makes the decision to undergo testing highly personal. How do you decide if testing is right for you? Here are things we recommend to Claire’s mom and others considering it.

Think about whether you have more trouble with your memory and thinking than others your age. Markers of Alzheimer’s disease begin accumulating years before the onset of cognitive impairment, but testing is currently recommended only for individuals who are already experiencing changes in memory and thinking. You may also weigh personal risk factors, like age and family history, that increase your risk for developing Alzheimer’s.

No, these tests can’t diagnose Alzheimer’s disease. Rather, the results can be considered, along with other information gathered by your health care provider, as part of a diagnostic process. As with many medical tests, there’s a chance of false positives, which could contribute to unnecessary anxiety.

Results are more like a snapshot than a crystal ball. Even if your result is negative and you don’t have Alzheimer’s markers now, you could develop them in the future. And evidence of Alzheimer’s markers does not necessarily mean you will develop dementia in the future.

To help people make this very personal decision, we developed a list of questions you can ask yourself.

How might I feel after learning the test results? Your feelings will likely vary depending on your result. For some, learning they do not have Alzheimer’s markers is a relief, while others are frustrated by the lack of explanation for perceived changes in their memory and thinking. People may feel anxious or distressed after learning they have Alzheimer’s markers, though they may also feel empowered by knowing more about their brain.

What might I do after getting the results? After learning they have Alzheimer’s markers, individuals often take action. Some adopt new behaviors to support brain health, while others make decisions about whether to retire sooner, where to live, or how to update legal documents like wills and advance directives. Some people want to use test results to buy long-term care insurance; however, learning this information may affect your ability to get coverage and the cost, so consider the advantages and disadvantages of buying insurance before testing.

Some people with Alzheimer’s markers may be eligible to take lecanemab, a drug recently approved by the U.S. Food and Drug Administration for treatment of Alzheimer’s disease. You would need to speak with your health care provider to determine whether this medication is right for you.

Consumer-initiated testing can be a powerful tool for learning about yourself in the comfort and privacy of home. But as tests for Alzheimer’s markers become more accessible, it’s important to think carefully about what learning these results might mean for you.

Claire Erickson is an associate fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania, and post-doctoral fellow at Penn’s Perelman School of Medicine. Emily Largent is a senior fellow at the Leonard Davis Institute of Health Economics and a professor of medical ethics at the Perelman School of Medicine.