Q&A: Shifting from Reactive to Proactive Care in Alzheimer’s Disease

Alzheimer’s disease care is being redefined with new advances, yet critical barriers must be overcome to realize their full impact

With Roberto Servi, SVP Global Marketing and Chief Marketing Officer, Lilly Neuroscience

Q: How is the Alzheimer’s global disease care landscape evolving, and what opportunities and gaps remain for early detection and intervention?

A: Alzheimer’s disease care is entering a new era worldwide—one defined by earlier detection, more precise diagnosis, and the possibility of slowing disease progression. New detection tools and diagnostics, such as the first FDA-cleared blood test for Alzheimer’s disease, can aid in diagnosing the cause of memory and thinking issues early when symptoms are present. These scientific advances are expanding what’s possible for patients and families, offering new options for timely planning, support, and care.

Around the world, health systems have the opportunity to rewrite the story of Alzheimer’s disease – moving from reactive care to proactive detection, diagnosis and intervention, grounded in hope and empowered decision-making. Still, the path ahead calls for continued focus on overcoming barriers such as gaps in primary care provider training and awareness, uneven access to specialists and public stigma—so that the latest innovations can reach those who need them most. 

Q: What are the main barriers preventing timely and accurate Alzheimer’s diagnosis, even as new tools and therapies become available?

A: Even as new diagnostics and disease-modifying therapies become available, significant barriers still stand in the way of making these innovations fully accessible and impactful. 

In the U.S., patients and families often encounter a complex path to care, shaped by low public awareness, lingering stigma, limited access to specialists, and gaps in provider training. For example, 20 U.S. states are projected to be “dementia neurology deserts” by 2025, with fewer than 10 neurologists per 10,000 people with dementia.¹ Insurance coverage and reimbursement challenges for new diagnostics and treatments create further delays. As a result, most people don’t receive confirmatory diagnostic testing, limiting their options for appropriate care and support. 

Further, a medical claims analysis commissioned by Lilly found that from 2021 to 2024, out of 6.5 million people who received an Alzheimer’s disease, dementia, or related diagnosis, only about 15% saw a specialist. Of those, 95% did not receive diagnostic testing for amyloid plaque—the pathological hallmark of Alzheimer’s disease. 

Prioritizing health system capacity is crucial so that long wait times for diagnosis and care do not remain the norm.

Similar challenges are evident globally. For example, a Lilly‑commissioned survey of neurologists across Spain, Germany, France, and Italy found that 97% of respondents said patients or their families often try to hide or downplay dementia symptoms during initial consultations—highlighting how stigma and denial remain major barriers to timely diagnosis. Closing these gaps must remain a global health priority, ensuring scientific advances are matched by awareness and readiness across healthcare systems.² 

Q: How large of a role does stigma play in delayed Alzheimer’s disease diagnosis and how can we work to change public perceptions around Alzheimer’s disease?

A: Stigma plays a significant role in delaying Alzheimer’s disease diagnosis by creating psychological, social, and systemic barriers. Changing these public perceptions is essential. 

Fortunately, how we talk about aging and brain health is evolving. We now have an opportunity to destigmatize and demystify Alzheimer’s disease, just as we have made progress in normalizing mental and cognitive health discussions. This shift is already underway in places like Japan, where the Kobe City project brings together industry, academia, and government to promote dementia-friendly communities. Lilly’s involvement has focused on public education to reduce stigma, encourage early detection, including dementia screening, and create a supportive path from detection and diagnosis to care.

Campaigns like Lilly’s “Brain Health Matters” are also driving this change on a global scale, encouraging people to prioritize brain health throughout their lives and making conversations about cognitive health a regular part of routine care. By breaking down the fear and uncertainty that keeps people from seeking help, we can ensure more individuals and families benefit from early intervention and support.

Q: How can policymakers ensure adequate funding and infrastructure to support early diagnostic initiatives?

A: Policymakers play a vital role in convening healthcare providers, payers, and advocates to create systems that can support rapidly evolving innovations. In the U.S., this means ensuring prompt Medicare and insurance coverage for new and approved diagnostic tests, so people get timely access to the latest tools.

Globally, governments can strengthen national plans for early detection and prevention, learning from countries that are taking proactive steps to address dementia. China’s National Action Plan for Dementia in the Elderly (2024–2030), for example, outlines a nationwide effort to build a dementia-friendly society and advance Alzheimer’s prevention and care. The Beijing Municipal Government’s accompanying 32 Measures reinforce this commitment by investing in the development of more accurate, rapid, and affordable diagnostic tools and treatments.

With the global economic burden of Alzheimer’s disease projected to reach $17 trillion by 2050, with $1 trillion expected to impact the U.S. directly, the urgency is clear: Alzheimer’s disease imposes a massive economic and societal burden, extending well beyond direct medical costs to affect daily life and family caregivers. By championing collaboration, investing in infrastructure, and holding all health partners accountable, policymakers can help ensure that the promise of innovation translates into real-world benefits for patients and families.

References

1. (2024), 2024 Alzheimer’s disease facts and figures. Alzheimer’s disease Dement., 20: 3708-3821. https://doi.org/10.1002/alz.13809
2. Ipsos. (2025). European neurologists’ opinions on Alzheimer’s disease. Ipsos UK. Retrieved October 17, 2025, from https://www.ipsos.com/en/european-neurologists-opinions-alzheimers-disease.