Diagnosing Alzheimer's: Home Screening Tests
With the internet at our fingertips, it can be tempting to take home screening tests for diseases or conditions or order at-home test kits. For a variety of reasons, this is highly discouraged. The diagnosis of Alzheimer’s disease is one that is made only after a variety of tests and careful consideration by trained professionals. Because of the complexity of the disease, it is often difficult for highly trained physicians and medical professionals with decades of training to make a definitive diagnosis of Alzheimer’s disease. Any at-home test cannot substitute for evaluation and diagnosis by a physician, especially one trained in memory disorders.
What is a screening test?
During the process of getting an Alzheimer’s diagnosis, a person goes through a variety of tests, including screening tests. A screening test is a test used to find potential health disorders in someone who does not have any symptoms of the disease.1 These kinds of tests are done for early detection in order for treatment to be most effective. These tests do not diagnose an individual, but are merely used to identify where further testing should be done to determine definitively whether a disease is present or absent, which is diagnostic testing.
SAGE (Self-Administered Gerocognitive Examination)
The SAGE (Self-Administered Gerocognitive Examination) is a 15-minute test that can be done at home with paper and pen and is said to help detect the earliest signs of cognitive impairment.2 It evaluates things like language, memory, and problem-solving, and is said to be highly sensitive. Although it is recommended that people talk with their doctors about the results, taking a test like the SAGE at home can cause unnecessary anxiety and concern when it may not be warranted. This is not a diagnostic test, nor does it account for any other explanations for cognitive impairment.
At-home genetic screening tests
In 2017, the Food and Drug Administration (FDA) approved an at-home genetic test through 23andMe’s Personal Genome Service Genetic Health Risk test.3 The test screens for genes associated with risks of certain conditions, including late-onset Alzheimer’s disease. The gene it screens for is the APOE-e4 Alzheimer’s risk gene. However, this is not as beneficial as this may sound. Having one copy of this gene increases one’s risk, and having two copies increases it even more – but this is just risk, not a determinant. This simply means a person is more likely to develop the disease than someone without the gene; it does not mean the person will develop the condition for sure. There are various other factors that go into the amount of risk the presence of these genes mean, and the test does not explain these factors – only a trained genetic counselor can do that.
A genetic counselor is someone who explains what genetic test results mean, how genes work in relation to risk and development of disease, and what specific genetic results mean for a specific person. At-home genetic tests do not allow for the possibility of interpretation and explanation by a professional, and the results can be misunderstood by a layperson. There is also the possibility of false positive results, which can cause unnecessary stress and fear. The Alzheimer’s Association is not in favor of any kind of at-home genetic screening test and states that it should not be used to replace a thorough examination and screening from a health care provider.4 A doctor uses multi-faceted tests, along with interaction and a physical exam to rule out differential diagnoses, making a false positive of Alzheimer’s disease much less likely in-person than from an at-home screening tool.
If an individual is concerned about the risk of developing Alzheimer’s disease or is concerned they may be exhibiting symptoms, talk with a doctor about it. The doctor may suggest also speaking with a genetic counselor, especially if there is a family history of Alzheimer’s disease or other cognitive disorders. While at-home screening tools may seem easy and convenient, there is a significant risk of misunderstanding the results, getting a false positive, and getting incomplete or inaccurate health information from these tests.