Alzheimer's and Dementia Risk: What You Can and Cannot Test

Alzheimer's disease and other dementias cannot be predicted from a single blood test in a person without symptoms. What you can do is keep together the results that clinicians use to look for treatable causes of memory problems and to follow heart health, and bring them to a clinician who knows you. This page says what the sources say is, and is not, testable. It is not a risk score and it does not say what your results mean.

What can be tested, and by whom?

• Cognitive testing. The Alzheimer's Association says cognitive, functional and behavioral tests evaluate memory, thinking and simple problem-solving abilities, and its primary care guideline says clinicians should use validated tools to assess cognition. This is done by a clinician, not from your lab results.
• Blood tests for other causes. The Alzheimer's Association says information from a physical exam and laboratory tests can help identify health issues that can cause symptoms of dementia, and names thyroid problems and certain vitamin deficiencies. MedlinePlus lists thyroid function tests including TSH, blood glucose, kidney markers and a vitamin B12 level.
• Alzheimer's blood biomarkers. The Alzheimer's Association says these tests are not screening tests for symptom-free people. Its primary care guideline says they are not recommended as stand-alone tests and are typically used in a specialist setting.
• Imaging. MedlinePlus says CT or MRI of the brain may be done to look for other causes of dementia, such as a brain tumor or stroke.

What does the guideline cover, and what does it leave out?

The Alzheimer's Association primary care guideline lists a basic set of first-tier laboratory tests that includes TSH, vitamin B12 and homocysteine. It says it applies to a patient with any severity of cognitive or behavioral impairment and does not consider individuals who do not have symptoms. The USPSTF found in 2020 that the evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment in adults 65 and older with no recognized signs or symptoms. Neither one is advice about what to do in your case.

What about APOE?

The Alzheimer's Association says carrying the APOE-e4 gene variant only indicates a greater risk and does not indicate whether a person will develop Alzheimer's. It also says health professionals do not currently recommend routine genetic testing for Alzheimer's, that at-home genetic tests are widely available, and that people considering testing should receive genetic counseling before a test is ordered and when the results are obtained. If you already have an APOE result, keep it with your records and discuss it with a clinician or genetic counselor. Phi Longevity PRISM does not order genetic tests and does not interpret them.

What about heart-health numbers?

The Alzheimer's Association says some of the strongest evidence links brain health to heart health, and that high blood pressure and diabetes are among the conditions that raise dementia risk. The CDC says conditions that damage blood vessels can also increase a person's risk of developing vascular dementia. That is why many people keep blood pressure readings, A1c and lipid results alongside memory-related tests. See our page on which heart disease risk tests to track.

A made-up example of what to keep

This is a made-up example for layout only. It is not a real person and it does not mean anything clinically.

• Vitamin B12: a value, a unit, a date, and the range printed on that report.
• TSH: a value, a date, and the printed range.
• A1c: a value and a date.
• Blood pressure: dates and readings.
• Any cognitive screening a clinician did: the name of the tool, the date, and who gave it.

Questions to ask your clinician

• Which tests have been done to look for treatable causes of memory problems, and what were the results and dates?
• Is a cognitive assessment appropriate for me, and who should do it?
• Do any of my medicines or other conditions affect memory?
• Would a blood biomarker test or an APOE test change anything for me? Should I see a genetic counselor first?
• Which of my heart-health results should we follow, and how often?

For general preparation, see what to bring to a specialist appointment and our guide to A1c and eGFR questions.

What to do with the files

1. Download your lab reports and visit summaries from each place you have been seen. Our guide to exporting your records from MyChart has the steps.
2. Connect MyChart at participating Epic health systems, or upload the reports, in your own account at philongevity.com.
3. Phi Longevity PRISM builds a one-page Care Team Brief with each result, its date, how it has changed over time and the guideline behind each flag, using the range printed on your own lab report. You print it or save it as a PDF and bring it to the visit.

Phi Longevity is not a healthcare provider or a "covered entity" under HIPAA for your personal account. We store your records in HIPAA-eligible systems under a signed business associate agreement with Google Cloud, and we protect them to that standard. You can ask us to delete your data at any time.

Your first Care Team Brief is free. Phi Longevity Complete is $29/month and keeps the brief current as new results arrive.

Start free: keep my results on one page →

What Phi Longevity PRISM does not do

It does not diagnose Alzheimer's disease or any dementia, does not assess memory or thinking, does not order or interpret genetic tests, and does not predict whether anyone will get a disease. It reads lab results today; medicines, diagnoses and allergies are not imported yet. It uses the range printed on your own lab report and never swaps in its own. A clinician decides what your results mean for you.