The burden
Alzheimer's disease is the most common cause of dementia. In the United States alone, an estimated six million people live with the disease, with many millions more in the prodromal phase — biomarker-positive but not yet symptomatic enough to meet a clinical diagnosis. The number is rising as the population ages, and projections through the next two decades describe continued growth.
The personal and economic toll is substantial. Direct medical care, long-term care, and the unpaid caregiving labor of family members together represent one of the largest burden categories in healthcare.
Where the science has moved
The current era is defined by the arrival of disease-modifying therapy. Anti-amyloid antibodies — lecanemab and donanemab — have demonstrated modest but real slowing of clinical decline in early Alzheimer's, and have full FDA approval. This is the first time in the history of the disease that any therapy has been shown to alter its underlying course in a randomized trial.
The science has also moved on diagnosis. Plasma biomarkers are entering routine clinical workflows, dramatically lowering the cost and friction of confirming amyloid pathology. Genetic stratification — particularly APOE4 status — is now part of the pre-treatment workup at most centers.
Where the delivery system has not
The operational system that has to deliver these advances is not keeping pace. Infusion-chair capacity, MRI scanner time for ARIA surveillance, and the supply of qualified specialists to confirm eligibility and manage treatment all act as binding constraints on rollout. The result is a treatment landscape in which the science is real but the access is uneven.
PatientSpotlight covers this gap — between what the science has demonstrated and what the system can actually deliver — across all of our work.