A study examining social media content related to Alzheimer’s blood tests has raised concerns about their promotion to asymptomatic individuals. The research, led by Dr Jenna Smith from the University of Sydney’s school of public health, analyzed 188 posts across Facebook, Instagram, and TikTok from accounts with a combined reach exceeding 114 million followers. The findings were published in the Journal of the American Geriatrics Society.
Blood-based biomarker tests such as p-tau217 and p-tau181 detect biological changes in the brain associated with Alzheimer’s disease. While these tests offer advantages over traditional diagnostic methods like brain imaging or lumbar punctures, major neurological organizations including the Alzheimer’s Association have established consensus that they should not be used for screening healthy individuals without symptoms. The tests require integration with other medical assessments and cannot be used alone for diagnosis. A critical distinction exists between detecting biological markers of disease and the actual development of clinical dementia symptoms; individuals may test positive without ever progressing to dementia.
The research found that more than one-third of analyzed posts promoted the tests for asymptomatic individuals. Approximately 10% of posts came from doctors claiming the tests could serve as screening tools, with most originating from the United States. Accounts with explicit financial interests proved more than three times as likely to promote the tests to healthy populations. Dr Smith noted that while some medical professionals shared nuanced information addressing limitations and potential harms, many lacked such balance.
Potential harms identified include unnecessary diagnoses and unclear treatment pathways. Healthy individuals who test positive face unknown treatment efficacy, as research on available therapies has focused on patients with mild cognitive impairment or dementia rather than asymptomatic carriers. Additional concerns encompass treatment costs and side effects, psychological impacts on patients and families, and insurance implications. In Australia, tests ordered through physicians cost up to $400 and are not covered by Medicare, while private online providers charge between $365 and $600.
Prof Susan Kurrle, president of the Australian and New Zealand Society for Geriatric Medicine, emphasized that tests should only be ordered by physicians in specific clinical circumstances. She cautioned that false positive results may create unfounded fears of inevitable dementia, while false negatives might discourage individuals from addressing modifiable risk factors such as exercise levels and vascular risk factors including LDL cholesterol, or hearing and vision loss.
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