Dementia is one of the defining health, economic and societal challenges of our time. Fifty-five million people are living with dementia today, a number that will triple over the next three decades, at a cost already exceeding $1 trillion annually.
But we can address it. While we have had symptomatic and non-pharmacological interventions for many years, after decades of investment in science and drug development, we finally have the first disease-modifying treatments for Alzheimer’s disease. Treatments that independent medicine regulatory authorities around the world have said are safe and effective. Real world evidence, which is beginning to accumulate, suggests patients are responding well to treatment.
These first disease modifying treatments are a starting point not a stopping point. They are the beginning of a transformation. And alongside this we have the rapid development of new diagnostic tools that are minimally invasive, such as a blood test. Science is taking us towards what people tell us they want: an early and accurate diagnosis and treatment options.
These first treatments slow disease progression, giving people time to plan for the future and to spend meaningful time with their loved ones. Decisions about treatment should reflect each person’s individual health priorities, goals and preferences, and be made with the guidance of a trusted clinician.
Yet in many countries, these treatments are not being reimbursed or funded by health systems. Even where reimbursement exists, access remains inequitable. Patients face multiple barriers: out-of-pocket costs that limit uptake, geographic barriers such as travel to specialist centres, and system delays including waiting lists and diagnostic bottlenecks. Health systems were not ready to deliver treatments.
For decades, Alzheimer’s and dementia movements have advocated for better investment in science, improvements in care, greater public awareness and stronger action on prevention. None of these priorities are diminished — nor should they be — by pharmacological interventions. Experience from other disease areas shows that the introduction of new treatments often accelerates progress across multiple fronts, strengthening care systems, driving earlier diagnosis and improving quality of support. The goal must be a multi‑pronged, integrated approach, combining pharmacological and non‑pharmacological interventions, to ensure the right treatments and supports reach the right person at the right time.
This moment calls for unity. As a field, we are navigating new territory: advocating not only for care and support, but for implementation of disease‑modifying treatments. We must come together to improve access, build confidence, and support health systems to deliver these disease-modifying treatments effectively. That requires sharing what we are learning, supporting one another to overcome barriers to access, and rapidly applying lessons from what is working and what is not.
We must also broaden the circle. The dementia movement is not only not‑for‑profit advocacy organisations. It includes clinicians, researchers, policymakers, industry, and people living with dementia and their families. And we should draw on the experience of other disease areas. Dementia is not the first field to see the introduction of disease-modifying treatments, nor the first to begin with treatments that are incremental rather than transformational. There are clear lessons on access, reimbursement, delivery and the move toward combination and integrated approaches that we can and must learn and apply.
People living with dementia deserve access to appropriate treatments and high‑quality care. That means the right to timely and affordable access to disease-modifying treatments. Together, we are committed to making that a reality.
Hilary Newton-Evans, CEO Alzheimer's Research UK, Dr Joanne Pike, President and CEO Alzheimer's Association, Michelle Dyson, CEO Alzheimer's Society, Professor Tanya Buchanan, CEO Dementia Australia, Professor Wiesje van der Flier CEO Alzheimer's Netherlands