Knowledge is power: How early detection is transforming Alzheimer’s care

Few diseases affect as many people as Alzheimer's disease. The diagnosis has long been viewed as a devastating sentence, leading to inevitable decline, leaving little time for treatment and placing a heavy burden on families. This sense of futility discourages patients and doctors from getting tested until symptoms are undeniable. This mentality must change.

In the past two years alone, progress has been faster than in the previous two decades. New drugs like Lequembi and Kinsula target some of the biology of the disease and slowed cognitive decline by about a third in clinical trials. Nearly 140 other treatments are in development, and more than 200 trials are ongoing globally. Treatments once thought impossible are becoming a reality.

But the real revolution is happening in diagnostics. Only 25 years have passed since the first imaging biomarkers were first able to detect disease in patients, and in that time imaging technology has advanced, spinal fluid tests have been discovered, and blood biomarkers have entered practice in the past seven years.

Alzheimer's disease is a co-pathological disease: amyloid aggregates into plaques and misfolded tau proteins form tangles in the brain, both hallmarks of AD. With recent advances, blood-based tests can now measure the pathological activity of misfolded tau protein, providing clear indications of Alzheimer's-related neurodegenerative disorders. As a result, we are now on the cusp of shifting the diagnosis of Alzheimer's disease from late forms to opportunities for early detection, where interventions can have the greatest impact.

We've seen this story before. The launch of Cologuard makes colon cancer screening easier and less invasive, increasing patient engagement in their own care. Coronary artery calcium scanning redefines heart disease prevention, turning invisible risks into visible evidence. Likewise, a convenient Alzheimer's blood test could change behavior, facilitate early screening, overcome denial, and enable treatment and lifestyle changes before symptoms appear.

The urgency is clear. By 2030, there will be more Americans over the age of 60 than children under the age of 5, and by 2050, if no treatment is found, an estimated 13-14 million Americans will have Alzheimer's disease. Alzheimer's disease costs the country more than $360 billion annually. Without early detection and action, the financial and emotional costs of the disease will skyrocket. Families deserve more than crisis-driven diagnoses that leave them with little time to prepare.

Research shows the benefits of early intervention. The US POINTER study, the Swedish FINGER trial and the Lancet Commission analysis all indicate that lifestyle choices – healthy eating, regular exercise, social interaction and controlling high blood pressure – can reduce risk or slow cognitive decline by up to 25%. Combining these approaches with the most effective clinical treatments that precede cognitive decline could provide the strongest defense against the disease to date.

Crucially, early detection changes the way patients and families experience the disease. Timely diagnosis can help families plan, make informed choices, and access resources. It replaces shock and helplessness with empowerment. When patients and caregivers see that testing leads to actionable steps, the futility stigma of Alzheimer's disease will diminish.

Equally important, as new diagnostic tools continue to emerge, neurologists and dementia care specialists are faced with an increasing number of patient referrals for testing, diagnosis, and treatment. An accurate blood test that could identify active tau pathology early and provide a clear “yes” or “no” answer would have tremendous clinical value. By detecting tau pathology associated with Alzheimer's disease before symptoms appear, early detection allows clinicians to effectively screen, prioritize patients most at risk, and expedite referral for neurological evaluation and care planning.

The market conditions for this shift have already taken shape. In a national survey earlier this year, the Alzheimer's Association found that nearly 80 percent of respondents were interested in learning whether they have the disease before it begins to impair daily life and were willing to proactively get tested before waiting for a doctor's recommendation. Even more impressive, 90% of respondents said they were interested in starting treatment to slow disease progression.

To seize this moment, we must integrate blood-based screening for Alzheimer's disease into mainstream care. This means educating physicians who may still be hesitant to recommend testing, updating guidelines to reflect emerging evidence, and ensuring cost is not a barrier.

We are at a turning point. Alzheimer's and other dementias rob older Americans not only of their memories, but also of their independence and dignity, eroding the fabric of families and communities. Now, for the first time, we have the tools to detect disease earlier, take action earlier, and change its trajectory.

Knowledge is power. With accessible screening, Alzheimer's disease's worst symptoms don't have to be an inevitable fate. Patients, families, and physicians must all choose to utilize these tools before symptoms appear so that tomorrow's generations inherit not fear, but hope.

Photo: wildpixel, Getty Images

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