Northwestern University psychologist Andrea Russell sees anxiety in older adults with early cognitive impairment. Some people worry that missing words or forgetting appointments can be a sign of Alzheimer’s disease. Some people are afraid of making mistakes in public. Some people are too scared to consult a doctor.
Seeing that uncertainty and the stigma surrounding dementia, Russell spearheaded a new study at Northwestern Medicine that found the majority of older adults are willing to undergo blood tests for biomarkers to assess their risk of Alzheimer’s disease.
The study will be published April 15 in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.
A survey of nearly 600 primary care patients (average age 62) found that 84% were unfamiliar with Alzheimer’s disease blood tests, and less than 2% had been tested before. However, after receiving a brief explanation about the test, 85% of respondents said they would take the test if their doctor recommended it.
An estimated 7.2 million older adults in the United States have Alzheimer’s disease, and that number is expected to nearly double by 2060. Most patients with early-onset memory problems initially visit primary care, where access to specialized tests such as brain scans and spinal taps may be limited. In comparison, newer blood tests are less invasive and potentially cheaper.
Last year, several tests that detect rates of amyloid, or tau, proteins associated with Alzheimer’s disease received FDA approval for individuals 55 and older with pre-existing symptoms of Alzheimer’s disease. However, the test’s accuracy and appropriate use are still being studied.
“These tests are not yet ready for widespread use, but they could be soon,” said study lead author Russell, an assistant professor of psychology in the department of psychiatry, behavioral sciences, and general medicine at Northwestern University Feinberg School of Medicine.
“As researchers, we strive to put patients’ needs first, so it’s important for us to know what patients think about these tests.”
what the patient said
The study was conducted from November 2024 to January 2025 among adults participating in three ongoing cohort studies in the Chicago area. All were over 21 years of age, had at least one chronic disease, and were primarily receiving primary care.
After brief education explaining that the test identifies higher risk but does not provide a definitive diagnosis, the following occurs:
- 94% said it was important to offer testing to patients with memory or thinking problems.
- 85% said they would agree to the test if their doctor recommended it.
- 60% said it was “very important” to offer annual testing to adults over 65, although such testing is not currently recommended.
The most endorsed reasons for potentially accepting a test were whether the results would be medically useful (94%), whether the test was covered by insurance (93%), whether comprehensive education was provided beforehand (88%), and whether the test was easy and convenient (88%).
The biggest barriers were cost (49%), concerns about test reliability (35%), fear of a positive result (22%), and concerns about being treated differently after a positive result (24%).
Nearly three in four participants said they expected psychological distress after a positive outcome. At the same time, about 87% said they were likely to take steps to improve their brain health.
What is healthy for your brain is also healthy for your body. People who learn they may be at increased risk may want to take steps to manage chronic conditions, improve nutrition, and continue medical care. These measures may help prolong their independence and well-being. ”
Andrea Russell, Northwestern University Psychologist
Early detection also helps patients plan ahead, access resources, and enroll in clinical trials as researchers continue to search for better treatments. “As health care providers, we may be missing out on opportunities to help people when they are motivated or need help,” Russell said.
“New cancer diagnosis”
In primary care, Russell works with patients who are experiencing early cognitive changes alongside chronic conditions such as diabetes and cardiovascular disease that increase the risk of dementia.
“I see patients whose lives are beginning to be shortened,” Russell said. “Some people are afraid to leave the house because they’re worried they’ll forget something or get lost. There’s so much doom and gloom surrounding Alzheimer’s disease that some people don’t want to know what’s going on. For many people, it feels like a new cancer diagnosis.
“Patients and families are often frustrated by delays in receiving a diagnosis of cognitive impairment or not knowing what to do,” she says. “They don’t know whether the cognitive impairment they perceive is an unrelated health problem, normal aging, or undiagnosed dementia.”
Test accuracy and limitations
Blood tests measure proteins associated with the amyloid plaques in the brain that are characteristic of the disease. Clinical trials have shown that these tests closely match, and in some cases surpass, results from PET scans and spinal fluid tests, the current gold standard for detecting Alzheimer’s disease.
However, results are not always conclusive, and a positive test result does not necessarily mean you will develop dementia. That means changes associated with Alzheimer’s disease are likely present in the brain at that time. Some people with amyloid plaques never develop significant cognitive decline, while others progress at different rates. Researchers continue to refine these biomarker tests and study how best to use them in primary care settings.
This study, “Patient Perspectives on Blood-Based Biomarker Testing for Alzheimer’s Disease in Primary Care,” was supported by National Institutes of Health grants R01AG030611, R01AG070212, R01AG075043, and P30AG059988.
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Reference magazines:
Russell, A. others. (2026). Patient perspectives on blood-based biomarker testing for Alzheimer’s disease in primary care. Alzheimer’s disease and dementia. DOI: 10.1002/alz.71247. https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.71247
