For people experiencing changes in memory and thinking, and for those who support them, an Alzheimer’s diagnosis can bring difficult questions about independence, treatment, and the future. It can also provide a starting point for informed decisions, appropriate guidance and resources, and potential opportunities to participate in clinical research.

The need for continued progress is substantial. An estimated 57 million people worldwide were living with dementia in 2021, with Alzheimer’s disease accounting for approximately 60% to 70% of cases.

Advances in biomarkers and disease-modifying therapies are changing how Alzheimer’s disease is identified, studied, and treated. They are also creating new considerations for clinical development, including how appropriate participants are identified, how eligibility criteria are defined, and how protocols can balance scientific rigor with the practical needs of participants and caregivers.

A timely diagnosis is a critical link between scientific progress and meaningful impact for patients. The 2026 World Alzheimer’s Month theme, “The Earlier You Know, The More You Can Do: A Dementia Diagnosis Matters,” reinforces that connection. Yet stigma and misunderstanding remain significant obstacles. According to the 2024 World Alzheimer Report, 80% of general-public respondents incorrectly believed dementia was a normal part of aging, highlighting a persistent misunderstanding that may contribute to barriers to diagnosis and care. Earlier identification may give patients and the people who support them more time to understand their options and make decisions that reflect their priorities. It may also help connect eligible individuals with clinical trials during the disease stages targeted by many investigational therapies.

Realizing the potential of these advances requires more than diagnostic and therapeutic innovation. It also requires clinical development strategies that consider the full participant journey, from diagnosis and referral through screening, enrollment, study participation, and follow-up. Biomarker requirements, visit schedules, invasive procedures, safety monitoring, and reliance on caregivers or study partners can all affect whether a trial is accessible and feasible for the people it is intended to serve.

We spoke with Lieza Exalto, a neurologist, principal investigator, and Senior VP, Neuroscience Medical at P95 Julius Clinical, about the value of earlier diagnosis, the factors that shape participation in clinical research, and the developments influencing the future of Alzheimer’s trials.

Why is early diagnosis important from your perspective as a neurologist and researcher?

Lieza Exalto: The brain is a vulnerable organ, so it is better to prevent damage than to try to restore what has been lost. With our current knowledge, we may be able to stabilize cognitive problems, but we are not yet able to restore cognition to a previous, higher level of functioning.

A healthy lifestyle can benefit brain health and has been associated with slower disease progression in some studies. The relationship between amyloid reduction and meaningful clinical benefit remains an active area of research.

When people hear “early diagnosis,” they often think about medical treatment. What are some of the less obvious benefits an earlier diagnosis can provide?

Lieza Exalto: An early diagnosis acknowledges what the patient, their family, friends, and loved ones may already be experiencing: that something is changing. In addition, it is important to counter the common misconception that dementia is a normal part of ageing.

Having an early diagnosis allows people to make decisions that fit their own situations and priorities. Someone may decide that they want to finally take that long-planned trip, participate in a research study, stop working, or move to a smaller home. The decision is up to the individual, but an earlier diagnosis gives them a greater opportunity to make those choices for themselves.

In your experience working with people living with Alzheimer’s disease and related dementias, what are patients most concerned about when they first receive a diagnosis?

Lieza Exalto: One of the greatest concerns is how quickly their cognition will decline. People want to know when they might reach a point at which they need help and can no longer live independently.

Unfortunately, it is not always possible to predict an individual’s course with certainty. That uncertainty can be very difficult for patients and families, which is another reason that open communication and early planning are so important.

Some argue that this uncertainty is a reason not to pursue an early diagnosis. Personally, especially given advances in drug development, I believe the potential benefits of an early diagnosis are increasingly important. It can help people explore available options and make decisions about their care and future while they are able to participate fully in those conversations.

The campaign theme suggests that an earlier diagnosis creates more opportunities to act. What are some of the most important things patients and families can do after receiving a diagnosis?

Lieza Exalto: They should talk openly about their situation, their wishes, and their personal dos and don’ts. These conversations can help make sure that future decisions reflect what matters most to the person living with the diagnosis.

Depending on the region, disease-modifying treatments such as lecanemab or donanemab may be available. In many regions, however, these drugs are not reimbursed. Where these treatments are available, the potential benefits and risks must be carefully weighed for each individual. Treatment consists of frequent infusions and brain MRI scans to monitor for potential side effects, which can make it costly and demanding.

Clinical research is another way people can take action after a diagnosis. How does an earlier diagnosis affect opportunities to participate in research?

Lieza Exalto: Most clinical trials target the early stages of Alzheimer’s disease. Patients who receive their first diagnosis at a more advanced stage may therefore have few, if any, opportunities to participate in certain trials.

The motivations for participating differ from person to person, but many patients and families are motivated by altruism. They hope that, through research, we will have more answers by the time their children or future generations might face a diagnosis. Others participate because they hope they may personally benefit from the investigational treatment.

Clinical research is often discussed in terms of scientific progress. What can clinical trial participation contribute for individuals today and for Alzheimer’s research in the future?

Lieza Exalto: Today, participants may be among the first patients to receive a new and potentially effective drug.

For the future, we learn from every clinical trial, whether or not the investigational treatment demonstrates the effect we hoped to see. Each trial gives us another piece of the large and complex Alzheimer’s disease puzzle.

A trial that does not meet its intended outcome can still improve our understanding of the disease, refine how future studies are designed, and help researchers determine which approaches should be pursued next.

Looking ahead, which developments in Alzheimer’s research make you most hopeful for patients and families?

Lieza Exalto: We are gaining more insight into the possibility that there is not just one type of Alzheimer’s disease. There may be several biological variants involving different disease pathways. If we can better understand those variants, we may be able to direct treatments toward the groups of patients who are most likely to benefit.

The development of reliable blood-based biomarkers is also important. Blood tests have the potential to become widely available, more affordable, and less invasive than a lumbar puncture or PET scan.

From Earlier Knowledge to Better Research

An earlier Alzheimer’s diagnosis does not eliminate uncertainty, but it can provide a starting point: an explanation for the changes patients and families have noticed, a path toward care and support, and an opportunity to participate meaningfully in decisions about what comes next.

As Exalto’s perspective makes clear, the value of knowing earlier extends beyond any single decision. It gives individuals and their loved ones time to discuss their priorities, consider their options, and determine whether participation in clinical research is right for them.

It can also create new possibilities for Alzheimer’s research. Earlier and more precise identification may help connect potentially eligible individuals with appropriate clinical trials, while advances in biomarkers and a deeper understanding of the disease’s biological diversity could support more targeted approaches to clinical development. Exalto’s own research has also highlighted how commonly used eligibility criteria, including cognitive scores and caregiver requirements, can influence who is able to participate in Alzheimer’s trials. Just as importantly, every study adds to the field’s collective knowledge and helps inform what comes next.

This World Alzheimer’s Month reinforces the value of earlier knowledge and the opportunities it can create. By turning that knowledge into thoughtful, patient-centered research, the clinical community can help shape the next generation of Alzheimer’s studies and, ultimately, the future of care.

This article is intended for general educational purposes and does not provide individual medical advice. People with concerns about memory, thinking, or other cognitive changes should consult a qualified healthcare professional.