Older US adults' experiences with and views about cognitive screening and blood biomarker testing for Alzheimer's disease

Introduction: Dementia is underdiagnosed in the United States. Understanding of older adults' experiences with screening is needed to optimize diagnosis.

Methods: US adults ages 65 to 80 (N = 1298) were surveyed on experiences with cognitive screening and blood biomarker (BBM) testing. Regression models estimated associations between characteristics and screening use.

Results: Most older adults were aware of screening (71%); 41% reported ever being screened. Older age, higher education, retirement, poorer health, and family history of dementia were associated with higher odds of screening; Hispanic and non-Hispanic Asian race/ethnicity were associated with lower odds (p < .05). Most older adults were unaware of BBM (81%); few wanted testing immediately (9%). Although older adults held positive views about screening and BBM, half reported concerns about distress or stigma if tests indicated risk.

Discussion: Cognitive screening rates remain low. Older adults view screening and BBM as useful to inform health decisions but have concerns about potential harms.

Highlights: Only one in five older US adults report having cognitive screening in the past year.Sociodemographic and health factors may influence whether older adults receive cognitive screening.Most older adults have positive views about cognitive screening and BBM testing.Many older adults would be concerned about distress or stigma if test result indicated dementia risk.