Screening for Alzheimer's: What Good Can It Do?

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I could write about different screening test controversies every day and not get caught up (but, indeed, may have a screening-post-of-the-day every day this week).

Alan Cassels, a drug policy researcher and author at the University of Victoria, British Columbia, and publisher of the Media Doctor Canada website (sibling to our site), has published a column in the November issue of Common Ground magazine under the headline, “Screening for Alzheimer’s: What good can it do?

His conclusion:

“…the drive to ‘screen’ people for Alzheimer’s is not being seriously questioned in the medical community because most people believe strongly in the “test early, test often” paradigm. That paradigm is not working out with mammography and prostate cancer screening and the question we should be asking is “Why should we expect anything different with Alzheimer’s?”

It’s a thoughtful analysis of the “test early, test often” message that dominates many screening messages. I encourage you to read the full column.

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Comments (6)

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Michael Kirsch, M.D.

November 2, 2010 at 8:44 am

There is a fallacy, of course, in many of the ‘test early’ strategies. Discovering a condition early may not change the natural history of the disease. For example, we can now discover lung cancer sooner than we could 20 years ago. But, are these folks really living longer? The term for this is lead time bias and this can confuse the public and those who report on health issues.

Ivan Oransky

November 2, 2010 at 3:48 pm

Good to keep in mind. Also, from one of my former students:
Totaled Recall: Is an Alzheimer’s Memory Screening Test Worth It?
Ivan Oransky, MD
Executive Editor, Reuters Health
Adjunct Assistant Professor, New York University’s Science, Health, and Environmental Reporting Program
Treasurer, Association of Health Care Journalists
Clinical Assistant Professor of Medicine, New York University School of Medicine
Blogger, Embargo Watch (a blog independent of Reuters that does not necessarily reflect its views)
Blogger, Retraction Watch (ditto)


November 6, 2010 at 3:55 pm

I will have to read Mr. Cassels article…
In the debate on screening, I often see reference to increased mortality, living longer. I don’t see as often reference to quality-of-life. Sometimes interventions reduce quality of life without extending life appreciably. This is a thorny topic because quality-of-life is subjective. I’d still like to see it wrestled.
(Maybe you’ve written about this elsewhere. I just found your site. I’m enjoying it.)