Alzheimer's disease has long been associated with a devastating lack of options for patients and their families. But new blood tests and treatments that can modestly slow cognitive decline in some patients are beginning to change that outlook, according to billionaire philanthropist Bill Gates, who says the next challenge is ensuring patients can access these advances.

In a recent article published on his website, Gates reflected on the progress made in diagnosing and treating the disease, which affected his father. He said that while the condition was once associated with helplessness, scientific developments meant 'we're not helpless anymore'.

However, Gates warned that the healthcare systems responsible for delivering these innovations had struggled to keep up with the pace of research. He described the slow uptake of new diagnostic tools and medicines as a major obstacle to improving outcomes for people living with Alzheimer's.

Blood Tests Could Make Alzheimer's Diagnosis Easier

One of the most significant developments is the emergence of blood-based tests that can help identify biological changes associated with Alzheimer's.

Previously, confirming the presence of amyloid proteins associated with the disease often required a positron emission tomography (PET) scan or a lumbar puncture to collect cerebrospinal fluid. These procedures can be expensive, invasive or difficult to access, potentially delaying diagnosis.

New blood tests offer a less burdensome alternative. In August 2026, the US Food and Drug Administration (FDA) cleared two additional tests, bringing the number of FDA-cleared blood-based tests for Alzheimer's to four.

The tests are intended to help assess people experiencing cognitive symptoms, rather than screen the general population. They also need to be interpreted alongside clinical assessments and other relevant medical information, rather than treated as standalone diagnoses.

New Treatments Can Slow Cognitive Decline

Gates also highlighted two antibody treatments, lecanemab and donanemab, which target amyloid proteins that accumulate in the brains of people with Alzheimer's.

Both medicines have been approved in the US for certain patients with early-stage disease. Clinical trials found that they could modestly slow the rate of cognitive decline, although neither reverses existing damage or cures the condition.

Another development came in July 2026, when the FDA approved a subcutaneous starting-dose option for lecanemab that can be administered at home by patients or caregivers. The regimen allows eligible patients to begin treatment with an injection rather than the traditional intravenous infusion.

However, these medicines require careful patient selection and monitoring. They can cause amyloid-related imaging abnormalities, including brain swelling or bleeding, making MRI monitoring important during treatment.

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Why Are Patients Still Struggling to Access Treatment?

Despite these advances, Gates said uptake has been slow because of limited awareness, lengthy specialist waiting times, regulatory obstacles and financial barriers.

Although primary care doctors can order certain blood tests, treatment is generally prescribed by memory specialists. Patients may therefore wait months for an appointment after receiving an initial positive result, potentially losing valuable time when treatment is most likely to help.

The practical demands of treatment can also be difficult. Some patients must travel regularly to specialist clinics for infusions and MRI monitoring, while the newer injectable option may involve higher out-of-pocket costs.

The access gap is also evident in England. Although lecanemab and donanemab have received regulatory approval in the UK, NICE has not recommended either for routine NHS use in its draft guidance, citing concerns about their cost-effectiveness. Final appraisals remain ongoing, meaning access through the NHS has not been established.

What Could Happen Next?

Gates said improving access will require better coordination between healthcare providers, researchers and companies developing diagnostic tools and medicines. He also encouraged greater participation in clinical trials, noting that researchers struggle to recruit volunteers from diverse racial and ethnic backgrounds, partly because participants need to live near trial sites and be able to travel.

Further research is exploring blood tests that detect tau, another protein associated with nerve-cell damage and cognitive decline, alongside medicines designed to target it.

Research has shown that diet, exercise and social interaction can reduce the risk of cognitive decline. Researchers are also investigating whether treating people before symptoms emerge might slow disease progression, delay its onset or even prevent it.

For Gates, the progress offers genuine grounds for optimism. But scientific breakthroughs will have limited impact if patients cannot reach them. The challenge now is ensuring that advances in diagnosis and treatment translate into meaningful improvements for the people and families affected by the disease.

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