Science
Opinion: Too many older Americans are getting tested for Alzheimer's
An 80-something patient came in for an annual visit recently and was worried that recent memory lapses might be symptoms of Alzheimer’s disease. This patient, like several others in my practice, has taken cognitive tests annually for more than a decade.
With each passing year, I see and hear the patient’s spiral of worry: Am I getting more forgetful? Perhaps it feels like “Where are my keys?” and “Where did I leave my wallet?” have become common refrains. These are simple memory lapses, an experience most people have throughout their lives, but they can be troubling as we get older. Are they signs of Alzheimer’s? Or signs of that other dreadful A-word … aging?
Year after year, for 10 years, in fact, this patient’s cognitive tests had come back normal. Until this year, when a blood test was positive for biomarkers for Alzheimer’s — triggering a further sense of panic. But here’s the problem: Science can’t yet tell us whether a positive test means the patient has an early stage of the disease. The only new data point was that this patient, so long dreading this day, had positive biomarkers showing increased risk for the disease. This person may not develop full-blown Alzheimer’s for five years or 20 years or ever. So did running that test have any benefit?
There is a sense of urgency in the medical community to classify a positive biomarker test as “Stage One Alzheimer’s Disease.” This is part of a larger desire to appear aggressive in fighting the disease, which for so long had no tests and no course of treatment.
I get that, and I understand why so many older patients fear Alzheimer’s, but I disagree with doctors whose response is to test early and often — and to diagnose Stage One Alzheimer’s based solely on biomarkers.
That categorization is potentially dangerous to patients, an unnecessary source of middle-of-the-night stress that can be deeply damaging to the very quality of life this person seeks to retain.
Such worries have become more widespread recently as the biomarker blood tests, marketed by companies like Quest and Labcorp, became commercially available so that patients could pay for them out of pocket. Previously, they were only used by clinicians in studies.
There’s an understandable impulse behind the medical community’s push to test lots of people. The more the disease is diagnosed, the more individuals will be identified for future treatments, and there is no doubt we need to improve recognition of early dementia, especially in medically underserved populations.
At the same time, pharmaceutical companies need more clinical trials — and also more patients — to develop new drugs to add to the array that already exists, such as Leqembi. In an aging nation with 7 million people already diagnosed with Alzheimer’s, we need these drugs, badly, but there’s no denying that profit lurks in the background as a motive here as well.
Although there are good reasons to test lots of people and gather a larger pool of patients who might have early stage Alzheimer’s, I think the cost to specific individuals can be just too great.
Candidates for clinical trials should not be identified based on positive blood tests from a clinical setting, but rather through carefully conducted research studies that have proper counseling and disclosure protocols.
More than 40% of individuals over 80 who take a biomarker test for Alzheimer’s will test positive. And it’s natural that many of them then will fixate on the worst-case scenarios and live their lives with a sense of worry and dread.
Patients who’ve tested positive come to me and bluntly state, “I have Alzheimer’s.” I see the scared look on their faces. Reaching this conclusion based on the biomarkers is like diagnosing cancer without doing a biopsy. The danger is real: Half of the patients who actually do have Alzheimer’s experience some sort of depression, and so do quite a few who think they have it — or worry they are sure to get it.
A positive blood biomarker test could also lead to significant mental and financial damage, with unnecessary and expensive procedures like an MRI, a PET scan or a spinal fluid test. Some people don’t like to hear this, but in many cases simple lifestyle changes like exercise, more rest and healthier eating could improve cognitive function. This is the recommendation I make to all my patients regardless of their Alzheimer’s risk.
For now, the biomarker test should be taken only if you are truly showing signs of Alzheimer’s disease. Here are some ways to tell: If a loved one is experiencing noticeable changes from their baseline mental abilities — such as losing track of time and place or struggling to find words — that can be a sign. Personality changes and new mood symptoms are other warning signs. Still, these symptoms should be distinguished from the slow and steady decline we will all experience.
If you do have symptoms, then yes, it could be time for biomarker tests, but only after thorough cognitive testing and a complete review of your medical history. That medical history could show other conditions such as sleep apnea that can influence memory. Lifestyle changes or treatments of those other conditions could resolve the troubling symptoms.
My stance on widespread testing will be different when doctors have more tools available to predict and treat Alzheimer’s and can offer constructive advice after a blood test comes back positive.
When someone has a cancerous tumor, surgeons remove it as soon as possible and start a treatment plan. When someone tests positive for the gene that indicates risk for a certain type of cancer, we monitor carefully.
A positive Alzheimer’s biomarker test, on the other hand, leads to no changes in clinical management when there are no cognitive symptoms. Prevention trials and improved predictive biomarkers for Alzheimer’s disease will change that, but we’re not there yet.
In the meantime, doctors’ oath to “do no harm” should mean we avoid overdiagnosing Alzheimer’s and fueling needless anxiety.
Keith Vossel is a professor of neurology at UCLA.
Science
Video: NASA Announces Artemis III Crew
new video loaded: NASA Announces Artemis III Crew
transcript
transcript
NASA Announces Artemis III Crew
NASA announced the crew of Artemis III mission, which will fly to low-Earth orbit to test rendezvous and docking maneuvers with one or two lunar landers.
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“I am excited to welcome you as the next crew in the Artemis journey to successfully return to the moon — this time to stay.” “I’m honored by the role that I’ve been given. I’m also very humbled by the task in front of us. But first and foremost, I’m grateful.” “So with that, the Artemis II crew, comrade, hands you the baton. You got the controls.” “As you know, we had a significant anomaly at our Launch Complex 36A on May 28. We’ve redoubled our efforts and are moving forward.”
By Alisa Shodiyev Kaff
June 9, 2026
Science
Santa Monica Mountains’ last steelhead trout survived the Palisades fire — and even had babies
Scientists feared the Santa Monica Mountains’ last remaining steelhead trout were dead, smothered by debris flows unleashed by the Palisades fire.
But the endangered fish surprised them: A team of biologists recently spotted 30 of the rare trout — and 21 babies — in Topanga Creek.
“There was a lot of happy dancing in the creek,” said Rosi Dagit, principal conservation biologist for the Resource Conservation District of the Santa Monica Mountains, which works with public and private landowners to conserve natural resources.
That’s because the steelhead here are endangered, at both the state and federal levels. Once, they swam in most streams of the Santa Monicas, but their numbers plummeted amid overfishing and coastal development. Increasingly frequent wildfire has further stressed their habitat. Topanga Creek, a biodiversity hot spot, is home to their last known population in the mountains that stretch from the Hollywood Hills to Point Mugu in Ventura County.
The trout that were spotted, including this one, are part of a distinct Southern California population that’s listed as endangered at the state and federal levels.
(RCDSMM Stream Team)
The California Department of Fish and Wildlife spearheaded a complex mission to rescue trout threatened by the Palisades fire that sparked in January 2025.
Time was of the essence. The fire hadn’t yet been fully contained. But rain was on the way, which would sweep massive amounts of sediment from the denuded hillsides into the water. Fish are often killed this way.
Crews stunned the fish with electricity, scooped them up in buckets, trucked them to a hatchery and ultimately moved them to Arroyo Hondo Creek in Santa Barbara County.
Within days, Topanga Creek was choked with mud. Some assumed the fish left behind were goners.
But in March, the conservation district’s team found four. The following month, when water conditions were clearer, they saw more.
“These fish continue to amaze me,” said Kyle Evans, environmental program manager for the state Department of Fish and Wildlife, who had seen the damage to the creek. “I had seen populations get wiped out in similar situations. So when I heard, I was thrilled.”
Evans surmises the fish that survived were in an area of the creek where less charred material and sediment were swept in.
“These fish likely hunkered down, were hiding under some rocks or places to try to get away from the main concentration of flow,” he said. “And luckily they weren’t buried.”
The ones that were spotted were fairly small, around 6 to 14 inches. Rainbow trout and steelhead trout are the same species, but with different lifestyles. If the fish remain in freshwater, they’ll be considered rainbows. However, they can migrate to the ocean and become steelhead, where they typically grow larger before returning to their natal waters to spawn.
Topanga Creek hasn’t fully recovered from the damage it sustained, but scientists say it’s looking better. Surveys last year were “so depressing,” Dagit said, with very few animals, and stretches that were essentially transformed into flat roads from all the sediment buildup. Some of the riparian canopy burned right down to the creek.
Then came 32 inches of rain over the last nine months, scouring out and moving sediment, creating deeper pools. Dagit said they recently found newt egg masses for the first time in years, as well as a few adult newts and many frogs. Plants that provide cover are starting to recover.
She provided photos comparing certain pools last year and this year, some dramatically transformed. In September 2025, the Shrine Pool could have been an overgrown hiking trail. This April, it was filled with shallow water.
The Shrine Pool in September 2025, left, and the same location in April 2026, right, with RCDSMM’s Isaac Yelchin donning a wetsuit.
(RCDSMM Stream Team)
Topanga Creek is home to another endangered fish, the small but hardy northern tidewater goby, often described as cute. Not long before the trout operation, Dagit led a rescue of hundreds of these fish too. Many were repatriated to the lagoon at the mouth of the creek in a moving ceremony last June.
There’s still the matter of what to do with the trout that were moved to Santa Barbara County last year. Evans would like to bring them home to the Santa Monicas at some point, but isn’t sure if it will happen. On one hand, they could bolster the small, genetically isolated surviving population. On the other, they might inadvertently bring in a disease or bacteria. There is some time to decide. Evans estimates the creek still needs to recover for two to three more years.
For now, the fish are functioning fine in their adopted creek. Experts worried the trauma wrought by the move would disrupt their spawning process, but they had babies that spring. This year, they spawned again.
Science
Pacifica pier cracks, another coastal casualty as seas continue to rise
The Pacifica Municipal Pier was shut down and taped off Thursday after city workers noticed cracks running through the landmark structure and concrete chunks falling into the ocean.
It’s just one of many coastal California structures that have recently crumbled under pressure from a rising and relentless ocean.
Officials from the small, beach city south of San Francisco said the pier was closed due to “cracking, separation, and displacement of the concrete walkway and structural elements.”
It will stay closed while structural engineers asses its safety.
Photos taken by city employees show a wide crack that runs from top to bottom and across the structure as well. Other photos show a large horizontal crack under the foundation of a small restaurant on the pier, the Chit Chat Cafe.
The cafe was also shut down.
This is not the first time the 53-year-old pier has shown signs of stress. In 2021, part of it was shut down after handrails along the edge collapsed. And in 2023, after a series of storms pummeled the Central California coast, damaging parts of the pier, the structure was partially closed for more than year.
Those same storms caused extensive damage in Aptos and Capitola, 70 miles south, where piers and waterfront infrastructure were swept away or damaged.
In 2024, a 150- to 180- foot section of the Santa Cruz wharf was ripped off by powerful waves.
At least 10 of the state’s dozens of coastal public piers were closed for part or all of 2024 due to structural damage sustained in winter storms since 2022. At least five others have longer-term upgrades planned to address structural issues.
“These things are costly to maintain,” said Zach Plopper, senior environmental director at Surfrider. “They are a part of our California coastal culture in many ways, but we’re going to need to reckon with, one, the state that they’re in, and two, the continuous and worsening threats they’re going to experience,”
He said most of the piers were constructed in the early 1900s, and they weren’t built to withstand decades of rough seas, storms and rising sea level.
“With this incoming El Niño, which is forecasted to be significant, and this marine heat wave we’re in the midst of, we’re kind of in uncharted waters as far as what this winter could bring in terms of storms and swells to the California coast, and we’re likely going to see a lot more damage,” he said. “Not just piers, but roads and other coastal infrastructure up and down the state.”
There was no storm in Pacifica earlier this week, so no single event could be blamed for the destruction.
However, a 2025 report from an outside engineering firm, GHD, found that several sections of the pier were in “poor” or “serious” condition, and they recommended closure before anticipated storms or events that could “subject the piles to high winds, swells and large waves.”
The firm found several areas of the pier where concrete was missing and rebar was exposed and corroding.
“The pier has continued to experience high winds and large waves in a harsh marine environment,” the engineers wrote in the report, noting that continuous exposure to seawater or marine spray was “detrimental” to the structure.
A 2023 city report estimated it would cost $19 million to repair.
That same year, a state law was enacted to require local governments along the California coast to plan for sea level rise in the coming decades.
Sea level has risen some 8 inches, on average, along the coast in the past 150 years, Plopper said, and researchers anticipate another foot in the next 25 years.
“We’re going to see profound shifts on our coastline, none that we have ever experienced before, and building static structures on the coast just doesn’t work all that well,” he said. “We’re going to have to make some really hard decisions.”
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