Early Detection of Dementia: What to Do Now – National Resources to Plan, Partner, and Act

The Urgency of Early Detection

Alzheimer's disease and related dementias are progressing from untreatable to partially manageable in their earliest phases, thanks to breakthroughs that have accelerated since 2023. Leqembi (lecanemab) and Kisunla (donanemab), the first FDA-approved drugs to target underlying amyloid pathology, slow cognitive decline by roughly 27-35% in people with mild cognitive impairment or mild dementia due to Alzheimer's. These therapies work best when started before substantial brain damage accumulates, making timely identification essential.

Diagnostic tools have evolved rapidly. In 2025, the FDA cleared blood tests like Lumipulse for detecting Alzheimer's-related biomarkers in symptomatic adults over 50, reducing dependence on expensive PET scans or invasive spinal taps. Research in 2026 continues to refine these biomarkers, with studies showing they can flag pathology 10-20 years before symptoms emerge. Initiatives such as the Davos Alzheimer's Collaborative's Early Detection Expansion Program and updates to the BOLD Infrastructure for Alzheimer's Act are embedding these tools into primary care and public health systems.

The stakes are concrete and escalating. Over 6.9 million Americans live with Alzheimer's today, a figure projected to nearly double by 2060 amid an aging population. Annual care costs already exceed $360 billion nationally, with much of that burden falling on families through unpaid caregiving or out-of-pocket expenses. Delaying diagnosis forfeits the chance to enroll in trials like AHEAD, which tests preventive use of Leqembi in high-risk asymptomatic individuals, or to implement lifestyle changes that evidence suggests could prevent up to 45% of cases.

Tensions persist beneath the optimism. Access remains uneven—racial and ethnic disparities in diagnosis rates and trial participation continue, and blood tests perform variably across diverse populations without integrated cognitive and imaging data. High costs of therapies (often tens of thousands per year) and risks like brain swelling (ARIA) require careful monitoring, raising questions about equity and scalability in routine care. Meanwhile, diagnostic advances are outpacing post-diagnosis support infrastructure, leaving many with early labels but limited ongoing resources.