This needs to include life-changing false positive rates. Imagine being given a diagnosis like this - people around you who know and any corporations who can sniff it out by snooping on your communications can lead to much rejection early in life. What happens when the diagnosis is as positive when it shouldn’t have been?
For a disease which (to my knowledge) can’t be slowed down or reversed, I think it’s a fair question why we would want to detect Alzheimer’s. Maybe there are other reasons, but my suspicion is that we will be able to, and an easy detection method significantly widens the pool of subjects to study later on.
If it turns out that driving a Prius on Tuesdays slows down Alzheimer’s, a larger pool of subjects would allow us to figure that out.
I would personally want to know as early as possible, so I could get my affairs in order and register my wishes around end of life care and euthanasia while I am still recognised as having full mental capacity.
It's also better for people around the Alzheimer's patient, as it will let them understand why someone's personality and behaviours may be changing, and possibly let them be bit more forgiving of such changes. It will also give family more time to plan and understand the health and community services and support are offered wherever they live.
I know two people who have been taking the new monoclonal antibody treatment for it. One who was a bit further along when she started, and did not show any significant improvement. The one who started while she was still in the early stages has completely arrested her descent. She hasn't recovered much of what she already lost, but she's still able to live independently and enjoy life, and her mental acuity scores are (slightly) better than they were last year. That's a hell of a thing.
It's very useful to understand what you're struggling from even if it's not curable. It explains your symptoms, your experience and help you understand what you're going through. Understanding that you're suffering from something incurable is also helpful in not looking for other ineffective methods to cure a mysterious illness.
The accuracy of this test is nowhere nearly good enough to do population-wide screening. The clinical setting for this test is memory clinics in which Alzheimers is already relatively highly likely differentially, and even there you're going to get a surprising number of false positives.
(There's enough info in the supplemental link on this page to have an LLM do the Bayes math for you.)
Most people get a dementia (or related) diagnosis after they are deep enough in it so that they cant do much about it or get their affairs in order.
My grandfather had a "fall" at work, he then left that job, and held down 2 more engineering jobs before he was diagnosed with a stroking condition and subsequent dementia. I got the distinct impression he thought he had more time, but rapidly declined.
If he knew he was short of time before his rapid decline he probably would have done things differently. Like not buying a house he would later have to sell to pay for aged care.
If he knew he was at risk of a workplace accident he probably wouldn't have worked as an after hours safety engineer at a major treatment plant, where if the worst had happened he could have endangered others.
Being able to know someone's risk factor would be important for how we treat elderly people. I know someone who is 85 and super sharp (previously worked as a corporate accountant and banker), they still have a better memory than a lot of 40-50 year olds, and yet they are constantly harassed by eldercare "agents" for the state because whenever they make a investment decision that is even slightly questionable they get reported to the state by the bank. Sometimes the bank refuses to authorize transactions. If they could conclusively prove they aren't at risk I think they would be left alone much more often.
At a personal level, I've been through this with my grandfather.
I want to know. My family wants to know. I want to prepare because there are things I want to do today that I know I won't be able to do in the future.
In many ways, it's just like many terminal cancer diagnoses. You're going to lose that person, but you have some time.
But it is a wildly variated, almost meaningless diagnosis. 3 of my 4 grandparents got Alzheimer's diagnosis as well as my mom and mother-in-law. The variation of progression and symptoms is so wide that it really seems like a catch-all. One grandmother was fine until about 72 and in 2 years forgot who people were and 4 years had lost all executive function and passed away. The other one was diagnosed in her early 80s and lived to be 96 with no major progression, like slightly more repeating, but never forgetting people or not knowing how to talk etc. Similar dichotomy between my mother and mother-in-law but with considerably different presentations of symptoms.
It's a weird disease and IMO not even really a disease it's a bunch of different causes of cognitive impairment under one umbrella but shouldn't be separated out much further to find actual causes and treatments.
If the patient still has periods of lucidity but the disease is suspected to be advancing, knowing they have it could prompt them to get their legal affairs in order.
I assume this is hugely beneficial for research on intervention methods, not for treatment. I think everyone is focusing on "I'd rather know" but imagine if you could get larger populations with a diagnosis earlier on, how impactful that would be for testing an intervention?
> Tell 50 million people they’re likely to have Alzheimer’s then tell them where to donate towards a cure, or treatments to slow it by a decade.
Pharmaceutical companies have spent something like $50 billion on developing Alzheimer's drugs with, well, the most furtive of straw-grasping to show for it. It's probably the most expensive single disease target (especially as things like cancer are families of diseases)... the failure to have good results isn't for lack of money, and merely throwing more money at it is unlikely to actually make progress towards meaningful treatments.
It just seems really obvious to me that it's not one disease. One problem with the research is that there is SO much money. It's corrupting. There's a whole thing about the plaque cartel and if you aren't testing around a possibly flawed concept the availability of funds is much lower.
I just feel the thinking is off, it's like we are trying to treat cuts by removing scabs and scar tissue. We really need deep investigation on the sources, which I feel in many cases are industrial chemicals and how some people's body / immune system respond to them.
One of the most compelling studies I saw was how distance from a Golf Course predicted neurodegenerative diseases, based on their use of certain pesticides.
Nobody is ever going to do that with this test, because the overwhelming majority of positive test results in a population-wide sample will be false, and the proposed diagnosis is devastating. This is a test for people who already have symptomatic dementia that helps confirm the diagnosis.
Well this test isn't for whether you will get Alzheimer's, so that disqualifies it before we even consider the accuracy.
But apparently your odds go above 30% if you live long enough, so if you could test for being in that cohort I think that result would be too common to actually be devastating.
Having struggled with hard to diagnose health issues before, I can’t emphasize enough how much of a relief it is to put a name on the disease that is causing you so much harm.
It is frankly shocking to think disease diagnosis would be a useless thing
For 20-ish% of Alzheimer's patients, the Shingles vaccine may be a treatment. This has been suspected for a few years now but has received recent confirmation studies.
If a loved one is suffering from this, this diagnostic would allow for interventions such as guardianship to assume financial and logistical responsibility for them with less subjective decisioning based on observations alone.
Even though it cannot be reversed or eradicated (yet, let's hope) detection can allow individuals to adopt interventions that help either adjust their lives to better cope with its progression or help mitigate some of the detrimental behavioral consequences. In addition, if you have family to care for it may be impetus to get certain things in order for them before later stages of the disease, etc. It's horrible and bleak, but I could certainly see why one might want to know.
In the lucky case, it can also relieve anxiety. Even though false negatives may still be possible, receiving a negative detection might give people who have anxiety about certain symptoms relief, since they can rule out (rightly or wrongly) a pretty severe disease.
One of interesting checks in this study might be to check when (if) any of the participants had taken this vax and what the impact might be on an Alzimer's diagnosis.
Purely anecdotal, but I witnessed a person starting to experience a severe cognitive decline right after the two doses of the Shingles Vaccine. It can surely be a coincidence, but I was very surprised when I read about this study.
I got bad news about the specificity for most things this serious. Think the only one we absolutely nail is infectious disease detection.
Spoilers: It's anywhere between 1-15 and 5-30% for false positives and 1-15/5-40 for false negatives. That's imaging, biomarkers, cancer screenings, etc
Like, where do you think the concept of "second opinions" came from? Whimsy? Lets go ask a second doctor if I actually have cancer, it'll be fun!
This needs to include life-changing false positive rates. Imagine being given a diagnosis like this - people around you who know and any corporations who can sniff it out by snooping on your communications can lead to much rejection early in life. What happens when the diagnosis is as positive when it shouldn’t have been?
This isn't a predictive test that someone could take in early life.
It's used to refine clinical diagnosis after patients present with cognitive severe decline.
By the time someone gets this test, they have severe problems. The purpose of this test is to assist with the right diagnosis.
As per the article, the test is used in conjunction with clinical diagnosis, not instead of.
For a disease which (to my knowledge) can’t be slowed down or reversed, I think it’s a fair question why we would want to detect Alzheimer’s. Maybe there are other reasons, but my suspicion is that we will be able to, and an easy detection method significantly widens the pool of subjects to study later on.
If it turns out that driving a Prius on Tuesdays slows down Alzheimer’s, a larger pool of subjects would allow us to figure that out.
I would personally want to know as early as possible, so I could get my affairs in order and register my wishes around end of life care and euthanasia while I am still recognised as having full mental capacity.
It's also better for people around the Alzheimer's patient, as it will let them understand why someone's personality and behaviours may be changing, and possibly let them be bit more forgiving of such changes. It will also give family more time to plan and understand the health and community services and support are offered wherever they live.
I know two people who have been taking the new monoclonal antibody treatment for it. One who was a bit further along when she started, and did not show any significant improvement. The one who started while she was still in the early stages has completely arrested her descent. She hasn't recovered much of what she already lost, but she's still able to live independently and enjoy life, and her mental acuity scores are (slightly) better than they were last year. That's a hell of a thing.
Wait what treatment is this?
It's very useful to understand what you're struggling from even if it's not curable. It explains your symptoms, your experience and help you understand what you're going through. Understanding that you're suffering from something incurable is also helpful in not looking for other ineffective methods to cure a mysterious illness.
The accuracy of this test is nowhere nearly good enough to do population-wide screening. The clinical setting for this test is memory clinics in which Alzheimers is already relatively highly likely differentially, and even there you're going to get a surprising number of false positives.
(There's enough info in the supplemental link on this page to have an LLM do the Bayes math for you.)
Most people get a dementia (or related) diagnosis after they are deep enough in it so that they cant do much about it or get their affairs in order.
My grandfather had a "fall" at work, he then left that job, and held down 2 more engineering jobs before he was diagnosed with a stroking condition and subsequent dementia. I got the distinct impression he thought he had more time, but rapidly declined.
If he knew he was short of time before his rapid decline he probably would have done things differently. Like not buying a house he would later have to sell to pay for aged care.
If he knew he was at risk of a workplace accident he probably wouldn't have worked as an after hours safety engineer at a major treatment plant, where if the worst had happened he could have endangered others.
> For a disease which (to my knowledge) can’t be slowed down or reversed
There's Lecanemab and Donanemab. The effects are modest however.
Being able to know someone's risk factor would be important for how we treat elderly people. I know someone who is 85 and super sharp (previously worked as a corporate accountant and banker), they still have a better memory than a lot of 40-50 year olds, and yet they are constantly harassed by eldercare "agents" for the state because whenever they make a investment decision that is even slightly questionable they get reported to the state by the bank. Sometimes the bank refuses to authorize transactions. If they could conclusively prove they aren't at risk I think they would be left alone much more often.
> why we would want to detect Alzheimer’s
At a personal level, I've been through this with my grandfather.
I want to know. My family wants to know. I want to prepare because there are things I want to do today that I know I won't be able to do in the future.
In many ways, it's just like many terminal cancer diagnoses. You're going to lose that person, but you have some time.
But it is a wildly variated, almost meaningless diagnosis. 3 of my 4 grandparents got Alzheimer's diagnosis as well as my mom and mother-in-law. The variation of progression and symptoms is so wide that it really seems like a catch-all. One grandmother was fine until about 72 and in 2 years forgot who people were and 4 years had lost all executive function and passed away. The other one was diagnosed in her early 80s and lived to be 96 with no major progression, like slightly more repeating, but never forgetting people or not knowing how to talk etc. Similar dichotomy between my mother and mother-in-law but with considerably different presentations of symptoms.
It's a weird disease and IMO not even really a disease it's a bunch of different causes of cognitive impairment under one umbrella but shouldn't be separated out much further to find actual causes and treatments.
> For a disease which (to my knowledge) can’t be slowed down or reversed, I think it’s a fair question why we would want to detect Alzheimer’s.
Getting an accurate diagnosis is always important. Cognitive decline could be caused by other problems, some of which are more treatable than others.
If this test came back negative it would suggest extra testing to rule out other conditions like a brain tumor or hydrocephalus.
If the patient still has periods of lucidity but the disease is suspected to be advancing, knowing they have it could prompt them to get their legal affairs in order.
I assume this is hugely beneficial for research on intervention methods, not for treatment. I think everyone is focusing on "I'd rather know" but imagine if you could get larger populations with a diagnosis earlier on, how impactful that would be for testing an intervention?
This again?
The test is optional. Feel free to skip it.
Tell 50 million people they’re likely to have Alzheimer’s then tell them where to donate towards a cure, or treatments to slow it by a decade.
> Tell 50 million people they’re likely to have Alzheimer’s then tell them where to donate towards a cure, or treatments to slow it by a decade.
Pharmaceutical companies have spent something like $50 billion on developing Alzheimer's drugs with, well, the most furtive of straw-grasping to show for it. It's probably the most expensive single disease target (especially as things like cancer are families of diseases)... the failure to have good results isn't for lack of money, and merely throwing more money at it is unlikely to actually make progress towards meaningful treatments.
It just seems really obvious to me that it's not one disease. One problem with the research is that there is SO much money. It's corrupting. There's a whole thing about the plaque cartel and if you aren't testing around a possibly flawed concept the availability of funds is much lower.
I just feel the thinking is off, it's like we are trying to treat cuts by removing scabs and scar tissue. We really need deep investigation on the sources, which I feel in many cases are industrial chemicals and how some people's body / immune system respond to them.
One of the most compelling studies I saw was how distance from a Golf Course predicted neurodegenerative diseases, based on their use of certain pesticides.
Nobody is ever going to do that with this test, because the overwhelming majority of positive test results in a population-wide sample will be false, and the proposed diagnosis is devastating. This is a test for people who already have symptomatic dementia that helps confirm the diagnosis.
Well this test isn't for whether you will get Alzheimer's, so that disqualifies it before we even consider the accuracy.
But apparently your odds go above 30% if you live long enough, so if you could test for being in that cohort I think that result would be too common to actually be devastating.
there are treatments that can help slow progression, especially if it's found early.
Having struggled with hard to diagnose health issues before, I can’t emphasize enough how much of a relief it is to put a name on the disease that is causing you so much harm.
It is frankly shocking to think disease diagnosis would be a useless thing
For 20-ish% of Alzheimer's patients, the Shingles vaccine may be a treatment. This has been suspected for a few years now but has received recent confirmation studies.
https://www.alzheimers.org.uk/news/2025-11-18/promising-rese...
If a loved one is suffering from this, this diagnostic would allow for interventions such as guardianship to assume financial and logistical responsibility for them with less subjective decisioning based on observations alone.
There are more personal practical reasons too.
Even though it cannot be reversed or eradicated (yet, let's hope) detection can allow individuals to adopt interventions that help either adjust their lives to better cope with its progression or help mitigate some of the detrimental behavioral consequences. In addition, if you have family to care for it may be impetus to get certain things in order for them before later stages of the disease, etc. It's horrible and bleak, but I could certainly see why one might want to know.
In the lucky case, it can also relieve anxiety. Even though false negatives may still be possible, receiving a negative detection might give people who have anxiety about certain symptoms relief, since they can rule out (rightly or wrongly) a pretty severe disease.
Well, the AI CEOs are telling we will have AGI in ~5 years, so with millions of agents with AGI this thing should be sorted soon ;)
Paper is at Springer Nature Link: https://link.springer.com/article/10.1007/s00415-026-13676-6
Since the recent discoveries about Shingles Vaccine delaying dementia https://hsph.harvard.edu/news/link-between-shingles-vaccine-...
One of interesting checks in this study might be to check when (if) any of the participants had taken this vax and what the impact might be on an Alzimer's diagnosis.
Purely anecdotal, but I witnessed a person starting to experience a severe cognitive decline right after the two doses of the Shingles Vaccine. It can surely be a coincidence, but I was very surprised when I read about this study.
94.5% is actually terrible.
If you have a prevalence of 10 in 1000, how do the numbers shake out?
Well, you test all 1,000. If we assume a 95% accuracy for false-positive and false negatives?
Of the 990 that you test that don't have the disease, the test will false state 50 do have the disease. Yikes!
And of the 10 that do have the disease? You'll miss 1 of them.
This improves the diagnostic accuracy from around 75% to 95%.
It's not terrible. This is a relatively good number. Diagnostics is just terribly difficult.
I got bad news about the specificity for most things this serious. Think the only one we absolutely nail is infectious disease detection.
Spoilers: It's anywhere between 1-15 and 5-30% for false positives and 1-15/5-40 for false negatives. That's imaging, biomarkers, cancer screenings, etc
Like, where do you think the concept of "second opinions" came from? Whimsy? Lets go ask a second doctor if I actually have cancer, it'll be fun!
Great but the big problem is how to actively treat it. Sleep is a huge factor and that’s a problem for us insomniacs :(