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Public safety occupations — including police officers, firefighters, paramedics, correctional officers, and military personnel — are generally considered safety-sensitive positions, meaning that impairment, fatigue, psychological difficulties, or significant judgment errors may create a risk of harm to the employee, coworkers, the public, or property. Fitness-for-duty evaluations (FFDEs) are intended to assess whether employees can safely perform these essential functions.

The professionals working in these occupations routinely encounter situations involving trauma, violence, human suffering, and critical incidents that most members of the public will never experience. While exposure to these stressors is often managed successfully, the cumulative effects of operational stress, psychological injury, and personal life challenges can sometimes affect an employee’s ability to safely and effectively perform their duties.

Research has consistently demonstrated that public safety personnel experience higher rates of mental health concerns than the general population, including post-traumatic stress disorder (PTSD), depression, anxiety, and substance misuse. At the same time, the vast majority of public safety professionals continue to perform their duties effectively, even when managing significant occupational stress.

Given this reality, FFDEs play an important role in balancing employee wellness, organizational responsibility, and public safety. Although they are sometimes viewed with suspicion or perceived as disciplinary measures, their purpose is to provide an objective, evidence-based assessment of an employee’s current functional capacity relative to the essential requirements of their role.

Fitness-for-duty evaluations are often conducted within broader occupational health or independent medical examination (IME) processes. However, psychological FFDEs are a specialized form of occupational assessment focused specifically on determining whether psychological factors are affecting an employee's ability to safely and effectively perform essential job duties. As a result, the motivation behind the assessment and the questions being addressed are slightly different from those in an IME.

When implemented appropriately, FFDEs support both employees and employers by helping identify risks, accommodations, treatment needs, and pathways toward safe and effective workplace functioning.

Memory loss has long been considered the defining hallmark of Alzheimer’s disease. But there is more to the disease than misplaced keys, forgotten names, and other memory lapses. Reducing Alzheimer’s to memory alone oversimplifies a disease that affects multiple aspects of thinking, behavior, and daily functioning.

As researchers develop more sophisticated biomarkers, disease-modifying therapies, and prevention strategies, they also recognize that the tools used to measure cognition must evolve. Alzheimer’s affects far more than memory, and understanding the disease requires assessing the full range of cognitive and behavioral changes that patients experience.

This theme emerged during the third episode of “The Progress Profile: Alzheimer’s Research in Focus,” in which Maria Carrillo, Ph.D., chief science officer and medical affairs lead at the Alzheimer’s Association, joined moderator Dr. John Harrison to discuss why the field is broadening its view of cognitive decline.