What is the value of an Alzheimer’s diagnosis?

• Alzheimer’s disease could impact 150 million people by 2050, creating an urgent need for scalable, earlier, and more equitable diagnosis
• Blood-based biomarker tests represent a breakthrough, bringing diagnosis closer to patients and reducing reliance on invasive, specialist-only procedures
• Transforming Alzheimer’s care requires a united effort across diagnostics, pharma, Alzheimer’s associations/charities, primary care, and patient advocacy to ensure system readiness and treatment access

When it comes to understanding the value of an Alzheimer’s diagnosis, it is critical to consider the rapid growth of the world’s aging population. Alzheimer’s disease imposes increasing pressure on healthcare systems due to its rising prevalence, since as longevity improves, the proportion of individuals susceptible to neurodegenerative conditions grows.¹ In the case of Alzheimer’s, the prolonged course of the disease, on average 8 to 10 years, exacerbates the strain on healthcare systems. This is because patients with Alzheimer’s require extensive resources, including ongoing clinical management, caregiver support, and institutional care facilities. 

There are also indirect costs that come with Alzheimer’s disease such as lost productivity and greater dependency on others.² Both direct and indirect costs intensify the burden on healthcare infrastructure and social services, whilst placing emotional and financial stress on unpaid carers and families. The growing impact of this disease underscores an urgent need for innovative medical technology and pharmaceutical solutions to improve Alzheimer’s diagnosis, treatment, and care.

In this interview, Olivier Gilliéron, Lifecycle Leader Cardiometabolic and Neurology at Roche Diagnostics, shares his thoughts on Alzheimer’s disease and the emerging innovations that are reshaping the patient pathway. He calls for increased collaboration across stakeholders to ensure that new and innovative technologies translate into improved patient care for more people.

HT: What is the current state of Alzheimer’s globally, and what disease trends are expected in the coming decades?

Olivier Gillieron: Today, over 55 million people live with Alzheimer’s globally, a number expected to nearly triple to 150 million by 2050, driven largely by aging populations.³ This rise presents not just a medical challenge but a profound social and economic one, with healthcare systems under increasing pressure to scale up diagnosis, treatment, and support.

At the same time, innovation is rapidly gaining ground. There have been significant recent advances in diagnostics, such as the advent of blood-based biomarkers and digital tools, as well as approvals of some of the first disease-modifying therapies.^4-7 With over 100 Alzheimer’s treatments currently in development, and multiple phase III trials coming out in 2025 alone, there’s growing momentum and real potential to shift the trajectory of this disease in the years ahead.⁸

HT: Why is an Alzheimer’s diagnosis, especially an early one, important?

Olivier Gillieron: Of the millions of people affected by Alzheimer’s worldwide, it is estimated that as much as 75% are currently living without a diagnosis.⁹ This unfortunate situation is due to a variety of social and economic factors, including stigma surrounding the disease, reluctance/fear of a diagnosis from patients and families, and importantly, a lack of readiness within healthcare systems.¹⁰ Many systems simply don’t have clear diagnostic pathways in place, making early diagnosis difficult but also more important than ever.

In terms of clinical outcomes, Alzheimer’s disease imposes a massive societal cost. The cost of Alzheimer’s is expected to reach $8.5 trillion globally by 2040, with two-thirds stemming from unpaid caregiving and lost productivity.¹¹ Early diagnosis supports families with care planning, reduces emotional and financial strain, and preserves quality of life for both patients and caregivers.

HT:  Can you elaborate a bit more on how an Alzheimer’s diagnosis, no matter when it happens, can positively impact a patient’s life?

Olivier Gillieron:  Diagnosing Alzheimer’s in early symptomatic stages now enables patients to access disease modifying therapies—new medicines that have demonstrated the ability to delay progression— in countries where they have been approved. Diagnosis also provides access to appropriate support services, provides opportunities for participation in clinical trials, and helps prevent the use of unsuitable medications and treatments with unproven benefits.

In driving towards a future where Alzheimer’s can be prevented, it is very promising that numerous diagnostic proteins can be detected decades before any symptoms occur. Evidence suggests nearly half of all dementia cases worldwide could be prevented or delayed by addressing 14 modifiable risk factors such as smoking, physical inactivity, and obesity.¹² Of relevance to diabetes, it is interesting to note that clinical trials are in progress looking at the impact of GLP-1 drugs on Alzheimer’s patients.¹³

It’s also important to note that, irrespective of age or treatment availability, patients should have the right to understand the cause of their cognitive impairment with the highest precision afforded by current technology. A diagnosis enables individuals to make crucial life decisions and make better plans for their future.

HT: What are some of the barriers to a diagnosis of Alzheimer’s globally?

Olivier Gillieron: Several factors contribute to the underdiagnosis of Alzheimer’s. As I mentioned, stigma plays a role. Many patients and families hesitate to seek a diagnosis, but system-level challenges are just as significant. Confirming Alzheimer’s typically requires invasive and costly procedures like PET scans or lumbar punctures, which are only available in specialist settings.

This creates a bottleneck: most patients start in primary care, yet diagnostic tools are concentrated in secondary care. To change this, we need to bring diagnostics closer to patients, empowering GPs with tools and training to identify and triage earlier.

Decentralizing diagnosis, supported by updated guidelines and collaboration across healthcare systems, could transform the Alzheimer’s pathway, enabling earlier diagnosis and easing pressure on specialists.

HT: What are the current technologies used to diagnose Alzheimer’s and what improvements can we expect to see in the near future?

Olivier Gillieron: Traditionally, Alzheimer’s diagnosis relies on a combination of cognitive screening tests and confirmatory diagnostics like PET scans and cerebrospinal fluid (CSF) tests. PET scans provide a visual representation of amyloid plaques in the brain, while lumbar puncture CSF tests measure the level of relevant proteins such as phospho tau 181 and amyloid-beta 42. Both methods are somewhat invasive and costly, requiring specialized medical personnel and equipment. In this current system, an early diagnosis is much harder to obtain since PET scans and lumbar punctures are impractical and costly for widespread early detection.

By contrast, new diagnostic innovations, such as blood-based biomarkers, look for certain proteins that can help to rule in or rule out Alzheimer’s with a simple blood draw. This has the potential to revolutionize Alzheimer’s care and treatment as this kind of test is less invasive, easily administered to more people, and could eventually be done in a primary care setting. Additionally and crucially, a blood test for Alzheimer’s is more cost-effective and more likely to enable an early diagnosis, both factors which would ease pressure on healthcare systems.

Very soon, blood-based biomarkers will be introduced in specialist settings, and once more guidance is established in the secondary care setting, blood-based biomarker testing for Alzheimer’s is expected to move into more decentralized care settings such as local clinics, pharmacies, and community health centers. Longer-term, blood-based biomarkers may also support pre-symptomatic screening, treatment monitoring, and even personalized care based on an individual’s biological profile.¹⁴

HT: How should healthcare organizations integrate these new technologies into practice and what should people take away regarding the future of the patient pathway for Alzheimer’s?

Olivier Gillieron: To make a meaningful impact, new Alzheimer’s diagnostics must be utilized in care pathways that include access to the most appropriate pharmacological and non-pharmacological interventions. Access to disease-modifying therapies remains limited, with geographical and care setting restrictions, highlighting the need for the evolution of both diagnostic and treatment infrastructure.

Blood-based biomarkers should first be adopted in specialist settings, where experience can shape updated guidelines. Over time, these tools can expand into primary care, enabling earlier and more equitable diagnosis. This shift depends on scientific consistency, such as standardizing test results across care settings.¹⁵

But system readiness requires more than technology. Education, investment, and collaboration across payers, clinicians, pharma, diagnostics, and patient advocates are essential. Encouragingly, we’re seeing this happen at cross-sector meetings like AD/PD in Vienna, where international professionals gathered to discuss, among other topics,  the diagnosis and treatment that will reshape the future of Alzheimer’s care.¹⁶

Indeed, these groundbreaking advances are making the future of Alzheimer’s look ever more promising. The next chapter will be defined by how well these innovations are integrated into existing healthcare systems and the power of united efforts among all stakeholders.