No longer treated as fate

I was nine when my great-grandmother forgot my name, and I learned then that dementia was treated as fate. I have been watching for signs that this is changing, and in the last two years I have seen three.

In May 2025 the FDA cleared the first blood test to help diagnose Alzheimer's, for adults 55 and older with symptoms. In July 2025 the U.S. POINTER trial reported on 2,111 older adults at risk, followed for two years. A lifestyle program improved their thinking, and a structured, coached version did more than a self-guided one. And since July 2024 Medicare has been running GUIDE, an eight-year model that pays for a care navigator, a support line open around the clock, and up to $2,500 a year in respite for family caregivers.

None of this is a cure. The FDA warns about false results, and the structured program's edge in POINTER was small. I worked on aging and Alzheimer's in two Harvard Medical School labs, so I know how far the science has to go.

The one that moves me most is GUIDE, because it pays attention to the person up at 2 a.m. with a confused parent. That person has been holding this together for free for a long time.

Piotr Kierner