The Silent Crisis We're Ignoring: Why Early Alzheimer's Diagnosis Must Be a Priority

My Grandmother Wasn't Just a Name — She Was the Heart of Our Family

My grandmother was more than just a family matriarch. She was the beating heart of everything we did. A vibrant woman from Queens, New York, she welcomed everyone into her home with open arms and an infectious laugh. Her Italian heritage gave her a boldness that was unapologetic, whether it was shouting commentary over movie soundtracks or cooking elaborate meals for her entire clan. I remember how much my mother joked that the boys she brought home often ended up falling in love with her instead.

But in 2006, something changed. My grandmother's personality, once so vibrant and full of life, began to slip away. She was diagnosed with vascular dementia — a condition that slowly eroded her ability to live the way she had always lived. The woman who made everyone feel special suddenly withdrew, becoming quiet and withdrawn. It was heartbreaking.

I watched her decline for nearly ten years, until she passed away in October 2016. That journey shaped me, and ultimately, it inspired a mission that I now carry with me every day: advocating for earlier diagnosis and better treatment options for Alzheimer's disease and related dementias.

Why Early Diagnosis Matters — And Why It's Still Not Happening

The statistics are staggering. On average, Americans wait more than three and a half years before receiving a dementia diagnosis. By that time, significant cognitive decline may have already occurred — meaning patients lose precious time when intervention could make the greatest difference.

We now have tools that can detect Alzheimer's years before symptoms become obvious. Blood tests, for example, are showing early signs of disease through biomarkers like P-tau217. These advances should be helping us save lives, but only if we act quickly and strategically to implement better diagnostic policies.

"We now have the first treatments shown to slow cognitive decline in the early stages of Alzheimer's disease. For years, our challenge was advancing the science. Now, our challenge is ensuring patients can access these advances."

I've spent years working within the Alzheimer's Association and now as Florida's Secretary of Elder Affairs, pushing for changes that would make earlier diagnosis not just possible — but routine. My goal is simple: give families like mine the time they deserve.

The Gap Between Science and Policy

For decades, research into dementia was underfunded and understaffed. The scientific community was working tirelessly to find answers, while I was on the frontlines of policy advocacy — trying to bridge that gap between science and implementation. Congress needs to step up and pass the ASAP Act, which would allow Medicare to cover FDA-approved Alzheimer's diagnostic tests for eligible patients.

This isn't just a medical issue — it's a moral one. We're failing millions of families who have already endured the heartbreak of watching loved ones disappear before their time. These aren't just statistics; they are real people whose lives were impacted by our lack of urgency in addressing early detection and treatment.

Standardized cognitive assessments during annual wellness visits could help identify early signs of cognitive decline. Right now, these evaluations vary wildly from practice to practice — and that's exactly where early warning signals go missing.

What Needs to Change Now

Let me be clear: I'm not asking for miracles. What I'm asking for is accountability — the kind that gives hope to families who have lost too much already. Here are some steps we must take:

• Medicare must require routine cognitive screenings during initial and annual wellness visits
• The ASAP Act needs immediate congressional action to cover Alzheimer's diagnostic testing
• We need to invest more in public education so families know how to recognize early warning signs
• Healthcare providers need better training to conduct consistent and accurate assessments

I've seen what happens when we delay diagnosis — and I won't let another family suffer that same loss. My grandmother's life mattered, and her story shouldn't have been one of silence and delayed care.

Our Time Is Running Out — But There's Hope

There is real progress on the horizon. New blood tests can now predict Alzheimer's risk up to ten years in advance. Lifestyle interventions are showing promise in preserving brain health as we age, especially when started early.

But without policy changes, these tools will remain out of reach for many who need them most. We're not asking for a cure yet — we're simply asking for the chance to slow the progression and maintain dignity for those affected by dementia.

My grandmother's legacy isn't defined by her final years, but by the love she gave us throughout her life. Now, it's our responsibility to ensure that future generations don't face the same devastating delay in diagnosis and treatment. It's time we change course — not just for the patients, but for all families caught in this crisis.

We can do better. We must do better. And together, we will.