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What to do if you’re worried about memory changes
Arrange an appointment with a healthcare professional, such as your primary care clinician. Bring someone who has noticed the changes, if you are comfortable doing so. A second person may be able to describe changes in daily life that are difficult to recall or assess alone.
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Before the visit, write down when the changes began and a few specific examples—for instance, a missed appointment, difficulty following a familiar task, or repeated questions. Note prescription and over-the-counter medicines, supplements, sleep or mood changes, and other health concerns. This information helps prepare for the conversation; it is not a self-diagnostic test.
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What happens during an Alzheimer’s evaluation?
There is no single symptom or test that establishes the diagnosis in every case. The clinician considers the pattern and progression of changes, thinking abilities, effect on everyday activities, medical history, and other possible explanations. The National Institute on Aging (NIA) describes several parts that may be included, depending on the person’s situation.
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Health history and daily function
The clinician may ask the person and a family member or friend about health, prior medical problems, medicines, daily activities, and changes in behavior or personality. The history helps put test results in context and identify changes that affect independence.
Thinking and memory assessment
Brief assessments may examine memory, problem solving, attention, counting, and language. These tests measure aspects of thinking; they do not, by themselves, explain why a difficulty is happening.
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Tests for other causes and supporting evidence
Standard blood, urine, or other medical tests may be used to check for health problems that could contribute to symptoms. A psychiatric evaluation may be considered. Depending on the clinical question, the clinician may also consider CT, MRI, or PET imaging, or analysis of cerebrospinal fluid (CSF), which is collected through a lumbar puncture. These approaches can support the evaluation and help assess alternative causes; not every person needs every test. See the NIA’s guidance on how Alzheimer’s disease is diagnosed.
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When the picture is not clear, repeat assessments can help show how memory and other cognitive abilities change. The clinician can explain what is known now, what remains uncertain, and whether follow-up is appropriate.
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What else can cause memory or thinking problems?
Alzheimer’s is not the only possible explanation. NIA identifies conditions and factors including stroke, a tumor, Parkinson’s disease, sleep disturbances, medication side effects, infection, and other dementias. Some causes may be treatable and possibly reversible, which is one reason an evaluation matters even when Alzheimer’s is a concern.
Do not stop or change a prescribed medicine on your own because you suspect a side effect. Tell the clinician what you take, including nonprescription products, so they can assess the risks and next steps.
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Can a blood test diagnose Alzheimer’s early?
A blood test can measure biomarkers—indicators of biological processes associated with Alzheimer’s—and may contribute evidence to a clinical evaluation. It is not interchangeable with a cognitive assessment, imaging, or CSF testing, and different tests may have different intended roles. NIA states: “At present, blood test results alone should not be used to diagnose dementia but may be taken into consideration along with other tests.” Its guidance also notes that access to diagnostic blood tests is limited and can depend on state-specific access and FDA-related guidance. Ask a clinician whether a test is appropriate and available where you receive care.
Performance figures reported for one test should not be read as a guarantee for another test or for an individual. In an August 14, 2024 summary, NIH Research Matters reported that a study of a blood test found 88% to 92% accuracy across participants, compared with 73% accuracy for clinical evaluations in specialty memory clinics and 61% in primary care. These figures describe that study, not every assay or person. Its participants were Swedish, and the summary said replication in more diverse populations was needed. The summary also described the test’s U.S. regulatory and insurance status at that time; those details can change, so check current status with a clinician or the relevant provider. Read the NIH Research Matters summary of the study.
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Blood, CSF, and imaging biomarkers are also used in research. NIA describes efforts to develop algorithms combining accessible measures, such as blood biomarkers and brief cognitive tests, as research programs. That work is not proof that a single screening method can diagnose Alzheimer’s in people without symptoms as part of routine care. For background, see NIA’s overview of diagnostic and prognostic algorithms and its biomarker explanation, reviewed January 21, 2022.
What can an early diagnosis help you plan?
A diagnosis may give a person and family more opportunity to discuss what is happening and plan next steps. NIA also notes that people diagnosed early may have more opportunities to participate in clinical trials or research studies testing possible new treatments. Trial access and eligibility vary, and diagnosis does not guarantee enrollment, an approved treatment, or a particular outcome.
How to choose the next step
There is no universally best test to request without knowing the person’s symptoms, history, and local access. A clinician can explain what a proposed test measures, whether it is intended to assess alternatives or support an Alzheimer’s diagnosis, how burdensome it is, and how the result would be interpreted alongside other evidence. Ask about availability, cost, and insurance coverage in your health system; these can vary by location and test.
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