THE EARLY DETECTION INITIATIVE
Don’t Wait to Ask
There are now treatments that can slow Alzheimer’s. Early detection gives you more time to live well. And it start with a cognitive test.
START HERE
What This Page is For.
This resource is for anyone who has noticed a change in their memory or thinking, anyone who has noticed a change in someone they care about, or anyone who simply wants to know where they stand.
There is one thing we are asking you to do. Get your cognition checked.
There are two ways to do it, and Medicare covers both. You can ask your own doctor for a cognitive assessment. You can also contact a virtual cognitive care provider directly, with no referral needed and usually a much shorter wait. Both routes are explained below.
WHY EARLY DETECTION MATTERS
Alzheimer’s Isn’t What it Used to Be.
For most of the last century, there was little reason to press for an early answer. Nothing could change the course of the disease, and a diagnosis offered information without options.
That is no longer the case.
The changes that lead to Alzheimer's disease begin in the brain years, often more than a decade, before memory or thinking are noticeably affected. By the time symptoms are clear to you and the people around you, a great deal has already taken place.
The treatments now available are approved for the earliest stages of Alzheimer’s and slow the disease rather than reverse it. What they protect is the ability you still have, which is why the point at which the disease is found matters as much as the diagnosis itself.
The earlier treatment begins, the greater benefit you will have.
What has changed?
Three developments over the past several years have changed what an early diagnosis is worth. Each one is a reason to raise cognitive health with your doctor sooner than you might have before.
TREATMENT
Therapies now slow the disease.
For the first time, FDA-approved therapies can slow the progression of Alzheimer's disease. They are approved only for people in the earliest stages, which means eligibility is decided by how early the disease is found. A delayed diagnosis can close a door that an earlier one would have kept open.
TESTING
Answers come much faster than they used to.
Evaluation once meant months of referrals and specialized imaging. Today it can begin with a brief assessment that your own doctor can perform, and newer blood-based tests can support physicians in confirming what is behind a change far faster than was previously possible.
TIME
An early answer is time you get back.
Time to begin treatment. Time to address other conditions affecting your thinking. Time to make decisions about your care and your future while those decisions are still entirely yours. And time to live well.
What an early answer makes possible
An early diagnosis is not only information. In practical terms, it opens options that narrow or close as the disease progresses.
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The therapies that slow Alzheimer's are approved only for people in the early stages of the disease. Whether they are an option for you depends largely on when the disease is identified.
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Thyroid conditions, vitamin B12 deficiency, sleep disorders, depression, and the side effects of common medications can all affect memory and thinking. Many are treatable, and some resolve entirely once addressed.
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Blood pressure, hearing loss, sleep quality, and medication interactions all influence how well the brain works. Each can be managed, and knowing where you stand now can help you form a plan.
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Most clinical trials of Alzheimer's treatments enroll people in the earliest stages of disease. An early diagnosis is frequently what makes participation possible at all. There are also studies available for cognitively healthy individuals and those with mild cognitive impairment.
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Preferences about care, finances, and legal arrangements are best set by the person they concern. An early answer leaves time to put those preferences in writing while everything is still clear to you.
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Families who know early can work through questions of housing, care, and cost at a reasonable pace. Families who learn late often face the same decisions all at once, under real pressure.
More than four in ten older adults showing signs of cognitive impairment are never diagnosed.
Memory changes are easy to overlook, and a routine appointment with your doctor rarely leaves time to explore them. Asking directly is what moves things forward.
RESOURCES
More on early detection, diagnosis, and cognitive testing
Films, guides, and research from the VoA library — written with and for people living with Alzheimer's.
UNDERSTANDING COGNITIVE CHANGE
Cognitive Changes are Worth a Conversation.
Almost everyone notices something as they get older. A name that takes a moment longer to arrive. The reason you walked into a room, gone by the time you get there. Most of the time this is ordinary, and your doctor will tell you so.
What doctors look for is a different pattern: changes that keep happening, and changes that have started to get in the way of an ordinary day. Telling one from the other is not something you have to work out on your own. That is what the appointment is for.
AGE-RELATED CHANGE
Slower recall, function holds.
Thinking slows somewhat with age. Recall takes longer, names surface a beat late, and a list becomes useful where it once wasn't. Daily life continues without adjustment.
MILD COGNITIVE IMPAIRMENT
Answers come faster than they used to.
Questions are repeated within a single conversation. The thread of a discussion becomes difficult to hold. Tasks performed for years take longer or are completed incorrectly. Family members have often observed the same changes. Many people with mild cognitive impairment remain stable for years, and some improve. Alzheimer's disease is one of several possible causes.
DEMENTIA
An early answer is time you get back.
Managing medications, handling finances, navigating familiar routes, or maintaining a household have become somewhat difficult. Alzheimer's disease is the most common cause of dementia, and identifying the underlying cause determines the appropriate treatment.
Some causes of cognitive change are reversible.
Cognitive symptoms are not always the result of a disease of the brain. Thyroid dysfunction, vitamin B12 deficiency, untreated sleep apnea, depression, and interactions between prescribed medications can each produce changes that closely resemble early dementia. Physicians test for these conditions routinely as part of an evaluation, and when one of them proves to be the cause, treating it frequently restores previous function.
For anyone weighing whether to raise the subject, this is the point worth considering. Declining to ask does not reduce the likelihood of Alzheimer's disease. It only postpones an accurate explanation.
WHAT TO EXPECT
A Cognitive Test is a Conversation, Not a Verdict.
Here is what happens during a visit.
BEFORE THE VISIT
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A few specifics are more useful than a general worry: when it started, what changed, whether anyone else has mentioned it. Tell the scheduler you want to discuss memory concerns so the appointment is long enough. Bring a partner, adult child, or friend, since they often noticed changes first. If you are booking a telehealth appointment, say the same thing when you schedule it, and ask whether the visit should be by video rather than phone.
THE VISIT
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Recalling a short list of words. Drawing a clock face. Following a sequence of instructions. Your doctor is looking at memory, attention, language, and problem-solving. There is no needle and no scan, nothing to study for, and no wrong answers. It fits inside a regular visit.
YOUR RESULTS
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A cognitive assessment cannot diagnose Alzheimer's on its own. It tells your doctor whether what you're describing shows up on a standard measure, and it establishes your baseline — which is what makes a change five years from now easy to see. Many people leave reassured.
IF MORE IS NEEDED
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The usual next step is lab work to rule out other causes — thyroid, B12, medication effects. Depending on those results, your doctor may order a blood-based Alzheimer's test or imaging, or refer you to a neurologist, geriatrician, or memory clinic. You and your family are part of every decision.
Takes a few minutes.
Part of a regular visit.
Not a diagnosis on the spot.
Takes a few minutes. Part of a regular visit. Not a diagnosis on the spot.
Establishes a baseline.
Available by telehealth.
Establishes a baseline. Available by telehealth.
COGNITIVE TELEHEALTH
Getting an appointment should not be the obstacle.
Telehealth is a way to see a memory specialist much sooner. There are now companies specifically dedicated to providing virtual cognitive health services. The process often starts with a short phone call. A member of their care team asks what you have noticed, answers your questions, and checks your insurance before anything is scheduled. No referral is needed, though your doctor can refer you. Visits take place virtually from home, and, if you wish, a family member can join from wherever they are.
During an appointment, a specialist reviews your history, does a cognitive assessment, and recommends and coordinates any further testing. You come away with an explanation of these results, a plan for what comes next, and ongoing care from the same team. Most of these organizations work with Medicare and major insurance plans and can schedule a visit within a few weeks.
To learn more or to get started, visit any of the organizations below.
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Can we do a cognitive assessment as part of my visit today?
What did the results show, and what do they mean?
Should I see a specialist and how soon?
Should I see a specialist and how soon?
What can I do right now - lifestyle changes, other conditions to manage?
Are there clinical trials I should know about?
Who in my family should be part of these conversations?
When should we check in again?
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Changes in memory or recall - repeating questions, losing recent conversations
Difficulty with tasks that used to be routine - bills, receipts, a familiar routine
Losing the thread in conversations, or trouble finding words
Changes in mood, motivation, or personality that others have noticed
Trouble following plans, instructions, or a sequence of steps
Anything a family member has noticed, even if you haven't
Synapticure offers expert virtual care from home for people with memory concerns, Alzheimer’s disease, and other forms of dementia in all 50 states. Our neurology providers specialize in memory care, with a dedicated care team to help patients and families find answers and support along the way. Synapticure accepts most major insurance plans, including Medicare.
BrainHealth.net, powered by NeuroVision, provides telehealth memory and dementia care through the BrainHealth Clinic and our GUIDE program for enhanced dementia support. We partner with primary care providers to help patients and families get answers sooner and support that lasts.
THE NEXT STEP
One Sentence is Enough to Start.
You don't need the right words, a complete list of symptoms, or any certainty about what's happening. You need one sentence and one appointment, whether in person or virtually.
SAY THIS
“I’ve noticed some changes in my memory, and I’d like to have a cognitive assessment.”
Your doctor takes it from there. If you're asking on behalf of someone else: "I've noticed some changes in my father's memory, and I'd like him to be assessed."
IF YOUR DOCTOR SAYS YOU SEEM FINE
It is reasonable to ask once more
“I would still like a structured assessment, so we have a baseline to compare against later.”
FREQUENTLY ASKED QUESTIONS
The questions people ask most.
WATCH
Check, Mate
Over a chess game they’ve played for forty years, one friend notices something in the other. Check, Mate is about the moment somebody decides to say it out loud.
RESOURCES
More on early detection, diagnosis, and cognitive testing
Films, guides, and research from the VoA library — written with and for people living with Alzheimer's.