Robert F Kennedy Jr, the nation's health secretary, has called for aggressive screening to detect Alzheimer's disease earlier. At the same time, his administration has essentially shut down the federal panel responsible for evaluating whether such screening actually works and should be covered by insurance.
The US Preventive Services Task Force, a volunteer panel of medical experts, was supposed to issue recommendations on cognitive decline screening this year. Instead, it has been prevented from meeting for over a year. The Trump administration fired two of the panel's chairs and has left at least eight vacancies unfilled on a committee that typically operates with 16 members.
In April congressional testimony, Kennedy criticized the panel as "lackadaisical and negligent for 20 years" before pivoting to call for better screening tools. "Screening for prevention is absolutely critical," he told a House committee. Days later, he told another panel that failing to deploy early Alzheimer's screening amounted to "regulatory malpractice."
The tension exposes a fundamental problem: experts say the evidence supporting broad Alzheimer's screening is weak, and the very panel designed to sift through that evidence and make recommendations is now sidelined.
"The evidence for cognitive screening for dementia is not great," said John Ruiz, a clinical psychology professor at the University of Arizona who recently rotated off the task force. He noted that neurologists lack consensus on how to assess cognitive decline. "You get 10 neurologists, you get 10 approaches."
The task force works by having expert volunteers assess which preventive services should be covered by insurance. Its recommendations carry real weight, shaping Medicare and Medicaid policy and influencing clinical practice. The panel's draft recommendations are open to public comment and typically receive substantial input from research communities trying to guide where evidence gaps exist.
That guidance mechanism now sits idle. Ruiz said the task force's traditional response to weak evidence is to recommend more funding for research to build the scientific foundation. "Put more funding into building the evidence, allow researchers to do screening studies," he explained.
Currently, Alzheimer's screening relies on symptom appearance, followed by cognitive testing and possibly neurologist referral or imaging like MRI scans. There is no major treatment for the disease, which affects an estimated 7.4 million Americans 65 and older, plus about 200,000 people of working age. That reality makes early detection potentially valuable if it could prompt lifestyle changes to delay cognitive decline.
Kennedy may be referring to new blood biomarker tests, specifically one for P-Tau217 approved last year, when he pushes for screening. The test is cleared only for people over 50 already showing signs and symptoms. But Kennedy did not specify which tool he had in mind.
Some researchers have urged caution. Ann D Cohen, co-director of the University of Pittsburgh Alzheimer's Disease Research Center, said the blood tests have "very good diagnostic" value but not "prognostic" value. Early studies also suggest the tests could generate false-positive results when used widely in real-world settings.
Cohen's own work on screening tools has been hampered by Trump administration policies unrelated to the task force. Funding freezes hit 14 of the nation's 35 Alzheimer's disease research centers, forcing hers to divert "several hundred thousand dollars" in philanthropic funds meant for blood biomarker research just to keep the clinic operating. "There's no way around the fact that science has been slowed down," she said.
An HHS spokesperson responded by highlighting other federal efforts, including continued NIH funding for Alzheimer's research and FDA oversight of new therapies. The agency said it is pursuing prevention, workforce development, and caregiver support through various programs.
Allison Aiello, a professor of health longevity and epidemiology at Columbia University, draws a distinction between developing screening tools and rolling them out broadly. Her population studies are hunting for biomarkers and cognitive tests that could detect changes as early as age 24 to 44. "Should we be doing that at every primary care visit? That's a whole other question," she said.
The disconnect between Kennedy's rhetoric and the actual state of the infrastructure meant to evaluate screening represents a peculiar policy moment. His calls for action come as the very mechanism designed to translate scientific evidence into coverage and practice recommendations has been disabled.
Author James Rodriguez: "Kennedy wants results on Alzheimer's screening without letting the experts who evaluate such things actually do their job."
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