By Craig M. Wax, DO
As a family physician, my colleagues and I are seeing more and more patients with memory and cognition concerns.
Too often, Alzheimer's care is treated as one-size-fits-all. In reality, effective Alzheimer’s care is about meeting patients where they are. That requires policies that prioritize early detection over crisis care, reduce barriers to treatment, and give physicians agency to do what is best for each individual patient.
The urgency behind the Alzheimer’s crisis is only growing. As the baby boomer generation ages, Alzheimer’s and related diseases are becoming more prevalent, with the number of cases expected to nearly double by 2050.
This is not just a health challenge; it's an economic one. Alzheimer’s costs Medicare roughly $174 billion annually and Medicaid another $72 billion on top of that. By 2060, it's estimated that the combined cost of formal and informal care for Alzheimer's could exceed $3 trillion.
Behind those staggering numbers are families absorbing the impact. Many patients, especially in the later stages of the disease, require round-the-clock support. Loved ones currently provide an estimated 6.8 billion hours of unpaid care each year—work valued at roughly $233 billion. We see adult children scale back careers and spouses exhaust themselves. Caregiver burnout becomes common, and expensive institutional care often follows.
Delay only makes it worse.
Alzheimer’s is progressive. Like cancer, the longer it goes undetected and unmanaged, the more complex and costly care becomes.
Fortunately, diagnosing Alzheimer's is becoming more straightforward. There are now blood tests that can accurately detect biological markers of the disease in its earliest stages–even before major symptoms develop.
An early diagnosis creates options. Patients can take meaningful steps to support brain health through simple interventions like regular physical activity. Walking around 5,000 steps a day has been associated with a reduced risk of cognitive decline – and researchers have identified a range of modifiable risk factors, from cardiovascular health to hearing loss, that can be addressed as soon as a patient knows their diagnosis.
These interventions are not cures, and their effects vary by patient. But they represent practical, low-cost ways to support brain health and improve quality of life—especially when introduced early.
For those patients who need more, the FDA recently approved two new therapies that slow Alzheimer's progression. The earlier they are used, the more they can help.
Unfortunately, our current system often works against early, individualized care. Primary care physicians lack the available time to conduct thorough, early cognitive assessments, counsel patients on risk reduction, and coordinate referrals, and insurance red tape delays and denies access to treatment. As a result, Alzheimer’s care remains scattershot, fragmented, and reactive. By the time the healthcare system mobilizes, patients and their families are often already in crisis.
We can, and must, do better.
First, we should encourage and pay for preventive strategies. Lifestyle interventions can help significantly, especially when started early. Clear, honest communication builds trust and sets realistic expectations.
Second, we must normalize prevention, early detection and counseling. Primary care physicians should have paid, adequate time and incentives to screen for cognitive concerns earlier and to discuss lifestyle changes, risk reduction, and long-term planning. These conversations allow families to prepare practically, financially and emotionally before decisions become urgent or it is too late.
Third, we must ensure timely access to medical treatment. Patients with established disease should not face avoidable delays caused by insurance denials and coverage disputes or administrative hurdles. Streamlining access through fair and honest coverage and reimbursement reduces patient suffering and overall downstream costs.
The goal is to shift Alzheimer’s care from crisis response to prevention, early detection, and action. Incentivizing early diagnosis, supporting prevention, and removing unnecessary barriers to treatment will not completely eliminate the disease. But these measures can reduce costs, ease caregiver strain, and preserve patient independence.
Alzheimer’s care should not be framed as a choice between lifestyle changes and medicine. What matters most is timing. When we act sooner – during the window when preventive steps can make a difference and treatments can have proven impact – we can ease the burden on families and avoid the staggering financial and emotional costs of late-stage care.
Craig M. Wax, DO, is a board-certified family physician, health policy expert, and media host.