"Understanding Breakthroughs in Brain Health: Top 10 Articles of 2025"—the latest report in the Gerontological Society of America's Insights & Implications in Gerontology series—presents a curated collection of the year's most impactful research on cognitive decline, dementia detection, and brain health across the lifespan. The report focuses on actionable insights for primary care providers, according to a Jul. 14 announcement.
Alzheimer's disease affects approximately 7.2 million Americans aged 65 and older, representing about 11% of that population. Health and long-term care costs for people living with Alzheimer's disease and other dementias reached an estimated $384 billion in 2025, with an additional $413 billion in care provided by roughly 12 million unpaid caregivers. Despite these figures, Alzheimer's disease remains significantly underdiagnosed, particularly during its earliest stages.
Soo Borson, MD, co-lead of the BOLD Public Health Center of Excellence on Early Detection of Dementia and professor at the Keck School of Medicine at the University of Southern California who served on the report's expert advisory panel, said: "Primary care is where most people with dementia are first diagnosed and where they receive most of their care. This collection of research gives clinicians the evidence they need to act earlier, more confidently, and more effectively for their patients."
The report highlights that primary care providers play a critical role in early detection and management of cognitive decline. Research included found that it takes an average of 3.5 years from symptom onset to dementia diagnosis—a delay that can limit access to therapies and timely planning. Only between eight to eleven percent of mild cognitive impairment cases are identified early; underdiagnosis disproportionately affects Black and Hispanic populations.
Advances such as blood-based biomarker tests are making diagnosis more accessible compared with traditional methods like PET imaging or cerebrospinal fluid analysis. Digital cognitive assessments are also emerging as practical tools that could be integrated into electronic health records.
Anna Pendrey, MD, DABOM, assistant professor at Indiana University School of Medicine who also served on the advisory panel, said: "Primary care providers are uniquely positioned to identify cognitive changes early and connect patients with the resources and interventions that can make a real difference. Incorporating cognitive screenings into routine visits, and normalizing conversations about brain health, are practical, high-impact steps that every practice can take." The report calls for stronger coordination among primary care teams after diagnosis due to increasing disability needs outpacing available support.
Other members serving on the expert advisory panel include Frederick Ketchum, MD, PhD; Mike Splaine; with support from Lilly.
