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At a visit in 2021 with her primary care doctor, Donna Purchase hesitated before answering a routine question. Her daughter Deborah Smith, who was with her, raised her eyebrows.

At a visit in 2021 with her primary care doctor, Donna Purchase hesitated before answering a routine question. Her daughter Deborah Smith, who was with her, raised her eyebrows. Her mother had been forgetful lately, she said, and Smith, who lives in Waldorf, Maryland, was concerned. Purchase, who is now 78, left with a referral for a memory test. The results were normal. “I knew I was fine,” said Purchase, who lives in Washington, D.C. But had she not been — had the test indicated cognitive impa