The story focuses on research presented a conference that found increased intensity of “forward compression waves” (FCWs) in the carotid artery was associated with an increased risk of dementia later in life.
The story didn’t tell readers this was an observational study–cause-and-effect couldn’t be established. Also, there is no discussion of the risks of this kind of screening test, notably the risk of false positives and false negatives.
The study does not, as the headline states, allow doctors to “spot dementia 10 years earlier.” This is an important distinction. Identifying important risk factors for dementia can be valuable, in part because it gives patients opportunities to make lifestyle changes that may reduce that risk. On the other hand, telling readers that a test can spot dementia “10 years earlier” makes it sound as if the outcome is a foregone conclusion.
Cost isn’t discussed. Various online estimates for carotid ultrasounds put them at $200-$800.
Here’s what the story says: “People with the most intense pulses, which pointed to a greater and more irregular blood flow, were up to 50% more likely to suffer reduced cognitive functions.”
First, we need to point out that it wasn’t a pulse researchers were measuring, but something known as forward compression waves (FCW) in the neck arteries.
The story doesn’t include vital data-driven information for readers, such as:
Also the story never makes it clear that, based on these observational study results, we don’t really know if doctors can “spot dementia 10 years earlier” just because of FCW. Nor that we have no know way of knowing to what extent identifying this risk allows patients to take action to improve their FCW score and therefore improve cognitive outcomes.
Some useful reading:
The biggest risk with a screening test like this is incorrect results–false positives and false negatives, which the story never explains. There is significant harm that can result if a person thinks they are at high risk of dementia when they aren’t, or thinks they’re at low-risk when they’re high risk. These are otherwise known as a test’s sensitivity and specificity and they should have been discussed, especially how these unknowns will guide next steps for future research.
The story never explains that the study is observational, so cause-and-effect conclusions can’t be drawn. It hints at the need for future research, which would have been a good segue to talk about the limitations of this study.
No disease mongering here. However, it is worth noting that the story does make one confusing statement. In a sentence immediately following a paragraph about dementia, the story states that “In the United States, the condition is the sixth biggest cause of death among all adults.” That’s inaccurate. Alzheimer’s disease, specifically, is the sixth leading cause of death among all adults, according to the CDC. Dementia and Alzheimer’s are lumped together by the UK’s Office for National Statistics, which may have led to the confusion.
The story does not address conflicts of interest. The study abstract notes that several researchers have ties to The Brain Protection Company. It is not clear to what extent that company may potentially benefit from the findings, if at all. The company does have patents related to dementia treatment (such as this one).
The story explains that researchers are attempting to see if the test should be added as part of “routine screening” for risk factors. It would have been helpful to briefly explain what is currently included in routing screening.
The story makes clear that more work needs to be done before this becomes anything approaching a standard of care.
The story doesn’t put this study in context of previous research. What is already known about FCW and dementia? Is the first study to find a pattern between the two?
The story does not appear to be based on a news release.