Fact Versus Fiction About
National Memory Screening Program
National Memory Screening Program is an ongoing initiative spearheaded by the Alzheimer’s Foundation of America (AFA), in collaboration with community organizations, that promotes early detection of memory problems as well as Alzheimer's disease and related illnesses, and encourages appropriate intervention. As part of National Memory Screening Program, qualified healthcare professionals offer free, confidential memory screenings as well as follow up resources and information about dementia and successful aging. These screenings are not a diagnosis, but can suggest whether a medical evaluation would be beneficial. Extensive study has indicated that these screenings are of value to individuals who participate in them.
Unfortunately, with an issue as sensitive as Alzheimer’s disease and related illnesses, there is often misinformation. AFA created this fact sheet to address some of the more common misconceptions about memory screening and National Memory Screening Program. AFA believes that all individuals should be empowered to make informed decisions to better manage their own health, not discouraged from screening based on misinformation.
Memory screenings are a significant first step toward finding out if a person may have a memory problem. Memory problems could be caused by Alzheimer’s disease or other medical conditions.
The memory screening tests made available to participating sites for use during National Memory Screening Program are validated for effectiveness. It is important to keep in mind that no medical test, whether for screening or diagnosis, is 100 percent accurate and any test can produce “false positive” or “false negative” results. However, the memory screening tests that AFA makes available for use during National Memory Screening Program (BAS, GPCOG, MIS and Mini-Cog) demonstrate 80 percent to 90 percent or higher sensitivity (probability of true positives) and specificity (probability of true negatives) in reviewed studies—similar to other established screening tests such as a mammography and Pap smear. In addition, a June 2008 study in International Psychogeriatrics found such tests to be minimally affected by education, gender and ethnicity.
Qualified healthcare professionals administer the memory screening tests on National Memory Screening Program. AFA explicitly recommends that qualified healthcare professionals—including social workers, pharmacists, physician assistants, psychologists, nurse practitioners and doctors—provide the screenings. AFA provides training materials to each screening site, and training videos are available to screeners on a secure website. The face-to-face screening takes place in a private setting in such venues as Alzheimer’s agencies, senior centers, long-term care facilities, doctors’ offices and pharmacies; only the individual being tested and the healthcare professional are present. The person who administers the screening reviews the results with the person who is screened, and suggests that those with abnormal scores and those with normal scores but who still have concerns follow up with a physician or other healthcare professional for further testing, as considered appropriate by that person’s own healthcare professional. The person who is screened receives the screening results to bring to his or her healthcare professional, as well as educational materials with information about memory issues and questions to ask the healthcare professional. Screening sites also provide information about successful aging, including the benefits of proper diet, physical exercise, mental stimulation, socialization and stress management.
Screening results do not represent a diagnosis. The screening is neither a diagnostic or case finding process. Screening tests in general simply help determine whether diagnostic tests should be considered. A “positive” result from a memory screening should never be interpreted as a diagnosis of Alzheimer’s disease or a related illness or other illnesses—no more than a “positive” mammogram means an individual has breast cancer. All of AFA’s materials clearly emphasize that memory screenings are used as an indicator of whether a person might benefit from an extensive medical exam, but that they are not used to diagnose any illness and in no way replace an exam by a qualified healthcare professional. AFA instructs screeners to encourage persons who screen positive or who still have concerns after being tested at local screening sites during National Memory Screening Program to have a follow up consultation with their primary healthcare providers, or other qualified healthcare professionals, and to bring the testing results with them.
Public awareness programs based on “warning signs” of Alzheimer’s disease are not a substitute for a structured screening or consultation with a primary care provider. It is important to know that the “warning signs” of Alzheimer’s disease have not been validated. Most of the warning signs may be indicative of a number of other health issues, including everything from depression (changes in mood/personality) to transient ischemic attack (problems with language/disorientation). There is often no mention that these warning signs may indicate other conditions. By the time any one or more of the warning signs presents the individual may be in the early moderate/moderate stage at best so “early detection” is a misnomer. Warning signs may be useful in raising public awareness about Alzheimer’s disease. However, elevating warning signs to an early detection tool and then placing the onus of recognition on those with the illness and their loved ones is not sound policy—especially given that anosognosia (unawareness of a problem of cognition in one’s self, usually to the point of vigorously denying the problem) is a common symptom for individuals with the disease.