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Opinion: Too many older Americans are getting tested for Alzheimer's

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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.

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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.

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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.

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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.

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Keith Vossel is a professor of neurology at UCLA.

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Video: ‘Very Successful Day’: NASA Completes Artemis II Launchpad Test

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Video: ‘Very Successful Day’: NASA Completes Artemis II Launchpad Test

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‘Very Successful Day’: NASA Completes Artemis II Launchpad Test

NASA successfully completed a rehearsal to launch the Artemis II rocket on Thursday. The mission would send astronauts around the Moon’s orbit for the first time in more than 50 years.

“Very successful day. I’m very proud of this team and all that they accomplished to get us to yesterday, and then to go execute with such precision.” “Following that successful wet dress yesterday, we’re now targeting March 6 as our earliest launch attempt. I am going to caveat that — I want to be open, transparent with all of you, that there is still pending work.”

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NASA successfully completed a rehearsal to launch the Artemis II rocket on Thursday. The mission would send astronauts around the Moon’s orbit for the first time in more than 50 years.

By Jorge Mitssunaga

February 20, 2026

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Fourth measles case confirmed in L.A. County; person visited LAX, restaurants while infectious

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Fourth measles case confirmed in L.A. County; person visited LAX, restaurants while infectious

A fourth measles case has been confirmed in Los Angeles County, prompting renewed calls from health officials for residents to ensure they are protected against the highly contagious virus.

The infected individual flew from Singapore to Los Angeles International Airport on Feb. 9 aboard Singapore Airlines Flight 38. The plane landed at about 7 p.m. following a 14-hour journey, according to the L.A. County Department of Public Health.

Over the following days, the individual visited a few San Gabriel Valley fast food restaurants, potentially exposing others to the measles virus.

“As measles cases increase, it is important that residents take steps to make sure they are fully protected,” L.A. County Health Officer Dr. Muntu Davis said in a statement. “The [measles-mumps-rubella] vaccine is the safest and most reliable way to prevent measles and protect yourself, your family, and your community.”

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The health department did not respond to questions from The Times regarding the sex or age of the infected individual, who was described in a statement as “a resident who recently traveled internationally.”

After arriving at and leaving the Tom Bradley International Terminal, the individual visited restaurants and convenience stores throughout Whittier and Montebello.

The individual ate at a Burger King in Montebello, 1212 West Beverly Blvd., on Feb. 10 between 5:30 and 7 p.m. The next day, the person dined at Taqueria El Atacor, 11156 1/2 Whittier Blvd. in Whittier, between 3 and 5 p.m.

The final two stops in Montebello were at Domino’s Pizza, 803 West Whittier Blvd., between 4 p.m. and 5:15 p.m. on Feb. 12; and 7-Eleven, 1106 West Beverly Blvd., on Feb. 13 between 4:30 p.m. and 5:45 p.m.

Those who were in the Bradley Terminal (Terminal B) on Feb. 9 from 7:30 p.m. to 9:40 p.m., or in the eateries above during the aforementioned time windows, may have been exposed to the measles virus.

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Symptoms typically develop anywhere from seven to 21 days after exposure, according to the health department.

Concerned individuals should confirm whether they have protection against the virus, either through past measles vaccinations or infections.

Those who are not immunized or are unsure of their status should monitor themselves closely for signs of infection. Common symptoms include fever, cough, runny nose or red eyes, as well as a rash.

Those with such symptoms are encouraged to stay home and avoid school, work and any gatherings. They should also call a healthcare provider immediately, but not go into a healthcare facility without informing them.

The monitoring deadline for symptoms ranges from March 2 at LAX until March 6 at 7-Eleven for individuals who visited those spaces around the same time as the infected person.

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Davis said the most effective way to protect against measles is to take the MMR vaccine. Children age 1 year and older are considered fully immunized after receiving two doses.

“Measles spreads easily and can lead to serious complications, including pneumonia, brain swelling, and even death,” Davis said. “We urge everyone to confirm their immunity and get the MMR vaccine if needed, especially before traveling. Taking this simple step helps safeguard your health and strengthens protection for our entire community.”

Previous cases confirmed in L.A. County so far this year also involved individuals who had traveled internationally. One of those individuals ventured to Sherman Oaks on Jan. 24, another to Woodland Hills on Jan. 30. The first case had no identified public exposure locations in L.A. County.

Measles cases have increased in the United States as vaccination rates have fallen in recent years, allowing the highly contagious virus to spread in communities with lower vaccine coverage.

According to the U.S. Centers for Disease Control and Prevention, there were 2,280 confirmed measles cases in the U.S. last year, the highest annual total since 1991. As of Feb. 12, 910 cases had already been confirmed nationwide this year — including 15 in California.

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Shark attacks rose in 2025. Here’s why Californians should take note

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Shark attacks rose in 2025. Here’s why Californians should take note

Shark attacks returned to near-average levels in 2025 after a dip the previous year, according to the latest report from the Florida Museum of Natural History’s International Shark Attack File, published Wednesday.

Researchers recorded 65 unprovoked shark bites worldwide last year, slightly below the 10-year average of 72, but an increase from 2024. Nine of those bites were fatal, higher than the 10-year average of six fatalities.

The United States once again had the highest number of reported incidents, accounting for 38% of global unprovoked bites when assessed on a country by country basis. That said, it’s actually a decline from recent years, including 2024, when more than half of all reported bites worldwide occurred off the U.S. coast.

In 2025, Florida led all states with 11 recorded attacks. California, Hawaii, Texas and North Carolina accounted for the remaining U.S. incidents.

But California stood out in another way: It had the nation’s only unprovoked fatal shark attack in 2025.

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A 55-year-old triathlete was attacked by a white shark after entering the water off the coast of Monterey Bay with members of the open-ocean swimming club she co-founded. It was the sole U.S. fatality among 25 reported shark bites nationwide.

It’s not surprising that the sole U.S. shark-related death occurred in California, said Steve Midway, an associate professor of fisheries at Louisiana State University. “In California, you tend to have year-to-year fewer attacks than other places in the U.S. and in the world,” Midway said. “But you tend to have more serious attacks, a higher proportion of fatal attacks.”

The difference lies in species and geography, Midway said. Along the East Coast, particularly in Florida, many bites involve smaller coastal sharks in shallow water, which are more likely to result in nonfatal injuries. California’s deeper and colder waters are home to larger species, such as the great white shark.

“Great whites just happen to be larger,” Midway said. “You’re less likely to be attacked, but if you are, the outcomes tend to be worse.”

Whether measured over 10, 20 or 30 years, average annual shark bite totals globally are actually very stable.

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“The global patterns change only slightly from one year to the other,” said Gavin Naylor, director of the Florida Program for Shark Research.

Those annual fluctuations are influenced by a combination of shark biology, ocean conditions and the number of people in the water at any given time in any given place, researchers say.

At the same time, global shark populations remain far below historical levels. Naylor categorizes about 30% of shark species as endangered, largely due to overfishing. In some countries, including the United States and Australia, stronger protections have allowed certain shark populations to recover.

Nevertheless, the risk of being bitten by a shark remains extremely low. The report notes that drowning is a far more common cause of death worldwide — and, if it helps you sleep (or swim), the data show that you are much more likely to be killed by lightning than you are by a shark.

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