"Do-It-Yourself" Dementia Testing: Issues Regarding an Alzheimer's Home Screening Test

Abstract

The Early Alert Alzheimer's Home Screening Test (AHST) is a variant of the Smell Identification Test (SIT) and the Cross-Cultural Smell Identification Test (CC-SIT), and recently became available for purchase by the general public. The validity and the practical utility of routine screening for individuals with asymptomatic cognitive impairment has not been established. There are considerable specific methodological concerns regarding the use of the AHST including the association of olfactory impairment with (a) age in the absence of cognitive impairment, (b) numerous acute and/or chronic medical conditions, and (c) lifestyle habits and social and/or demographic variables. General public misunderstanding of the difference between a screening and a diagnostic test, primary care physicians' frequent confusion about follow-up mechanisms for newly diagnosed patients with dementia, the possible lack of perceived counseling options for those self-diagnosed, and abuse of test findings create distinct possibilities for misuse of this test. The marketing of the AHST and its general use without appropriate public health educational safeguards is inappropriate and may be unethical.

High Interest in Screening and Treatment for Mild Cognitive Impairment in Older Adults: A Pilot Study

“…One concern is the development and aggressive marketing of over-the-counter commercial products for memory testing whose efficacy is questionable. 18 Another concern is the potential ''labeling'' effect of the diagnosis of MCI. People who, by definition, have no functional impairments could experience negative social and psychological consequences from being told they have a condition with serious consequences and only marginally effective therapies available.…”

“…14 This has accompanied studies reporting ''efficacy'' in treatment with cholinesterase inhibitors. [15][16][17] Although anecdotal evidence suggests rising public interest in screening for dementia, 18 nothing quantitative is known about public interest in screening for MCI. A pilot study was therefore conducted with a convenience sample of older adults in Chicago to assess their interest level in screening for and treating MCI.…”

Identifying Early Markers of Alzheimer's Disease using Quantitative Multiplex Proteomic Immunoassay Panels

“…A number of noninvasive screening tools for early AD have been reported in the literature including short psychometric tests, 32 EEG tests, 33 optical approaches, 34,35 olfactory tests, 36 and blood‐based tests 37,38 . Not all have been successfully established as reasonably accurate screening tools.…”

Biomarkers in the Diagnosis and Prognosis of Alzheimer’s Disease

“…The Alzheimer's Home Screening Test (AHST) is a "scratch and sniff" odor-identification test based off an observed, statistically significant correlation between olfactory dysfunction and AD. [22][23][24] Another home screening test is the Minnesota Cognitive Acuity Screen (MCAS). This test simulates a doctor-proctored examination.…”

“…21 In addition, waiting for symptoms to arise makes early diagnosis and treatment very difficult. Many home screening tests have been marketed to assist with diagnosis [22][23][24][25][26][27] (Table 1); however, more effective diagnostic techniques are needed.…”