A patient around 80 years old recently came in for an annual visit and was concerned that recent memory lapses were symptoms of Alzheimer’s disease. This patient, like several others in my practice, has had cognitive testing every year for over a decade.

With each passing year, I see and hear the patient’s spiral of worry: am I forgetting more and more? Maybe it sounds like “Where are my keys?” and “Where did I leave my wallet?” have become common refrains. This is simple memory loss, an experience that most people have throughout their lives, but which can be troubling as we age. Are these signs of Alzheimer’s? Or signs of that other terrible A word… aging?

Year after year, for 10 years in fact, this patient’s cognitive tests had returned to normal. Until this year, when a blood test came back positive for Alzheimer’s biomarkers, triggering additional feelings 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, who had dreaded this day for so long, had positive biomarkers showing an increase risk for illness. This person may not develop full-blown Alzheimer’s disease for five years, 20 years, or ever. So, did running this 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.” It’s part of a broader desire to appear aggressive in the fight against the disease, for which for so long there was no test or treatment.

I understand this and I understand why so many older patients fear Alzheimer’s, but I disagree with doctors whose answer is to test early and often – and diagnose stage one Alzheimer’s. based solely on biomarkers.

This categorization is potentially dangerous for patients, an unnecessary source of stress in the middle of the night that can be profoundly detrimental to the very quality of life that person seeks to maintain.

These concerns became more widespread recently when biomarker blood tests, marketed by companies like Quest and Labcorp, became commercially available so patients could pay for them out of pocket. Previously, they were only used by clinicians in studies.

There is an understandable impulse behind the medical community’s desire to test large numbers of people. The more the disease is diagnosed, the more people will be identified for future treatments, and there is no doubt that we need to improve recognition of early-onset 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 already existing range, such as Leqembi. In an aging country with 7 million people already diagnosed with Alzheimer’s disease, we desperately need these drugs, but it is undeniable that profit lurks in the background as a motivation here too.

While there are good reasons to test large numbers of people and bring together a larger number of patients who may have early-stage Alzheimer’s disease, I think the cost for some people may be simply too high.

Candidates for clinical trials should not be identified based on positive blood tests performed in a clinical setting, but rather through carefully conducted research studies with appropriate counseling and disclosure protocols.

More than 40% people over the age of 80 who take a biomarker test for Alzheimer’s disease will test positive. And it’s natural that many of them then focus on the worst-case scenarios and live their lives with a sense of worry and dread.

Patients who test positive come to me and state bluntly: “I have Alzheimer’s disease.” I see the scared look on their faces. Reaching this conclusion based on biomarkers is like diagnosing cancer without taking a biopsy. The danger is real: half of the patients who TO DO have Alzheimer’s disease experiencing a kind of depressionjust like many who think they have it – or who fear being sure they will.

A positive blood biomarker test could also lead to significant mental and financial harm, with unnecessary and costly procedures like an MRI, PET scan, or spinal fluid test. Some people don’t like to hear this, but in many cases, simple lifestyle changes, such as exercise, more rest, and a healthier diet, could improve cognitive function. This is the recommendation that I make to all my patients regardless of their risk of Alzheimer’s.

For now, biomarker testing should only be done if you actually have signs of Alzheimer’s disease. Here are some ways to tell: If your loved one is experiencing noticeable changes in their basic mental abilities, such as losing track of time and place or having trouble finding words, this may be a sign. Personality changes and new mood symptoms are other warning signs. However, these symptoms should be distinguished from the slow, steady decline that we will all experience.

If you have symptoms, then yes, it may be time for biomarker testing, but only after thorough cognitive testing and a complete review of your medical history. This medical history could show other conditions such as sleep apnea that may influence memory. Lifestyle changes or treatments for these other conditions could resolve the worrying symptoms.

My position on widespread testing will be different when doctors have more tools to predict and treat Alzheimer’s disease and can offer constructive advice after a blood test comes back positive.

When a person has a cancerous tumor, surgeons remove it as soon as possible and start a treatment plan. When someone tests positive for the gene indicating a risk of developing a certain type of cancer, we monitor carefully.

In contrast, a positive test for Alzheimer’s disease biomarkers does not result in any change in clinical management in the absence of cognitive symptoms. Prevention trials and improved biomarkers predictive of Alzheimer’s disease will be game-changers, but we’re not there yet.

In the meantime, doctors’ oath to “do no harm” should mean we avoid overdiagnosing Alzheimer’s and fueling unnecessary anxiety.

Keith Vossel East professor of neurology at UCLA.