Earlier dementia diagnosis could improve care, reduce downstream costs

Efforts to detect dementia earlier in primary care could have more effects on patient outcomes and healthcare costs, even beyond the use of new therapies.

A program supported by Independence Blue Cross (IBX) and led by Jefferson Health is focused on improving early identification and management of cognitive impairment. Although new Alzheimer’s treatments such as Leqembi (lecanemab) and Kisunla (donanemab) have drawn attention, experts say the larger impact may come from earlier, more coordinated care.

Rodrigo Cerdá, M.D., M.P.H., senior vice president of health services and chief medical officer at IBX, and member of Managed Healthcare Executive’s editorial advisory board said earlier diagnoses can help prevent complications that often lead to hospitalizations.

“You could prevent that by getting an earlier diagnosis, getting (patients) involved, getting their caregivers involved, thinking about how you're going to make sure that they're on top of all their healthcare needs earlier,” Cerdá said. “Some of those things are not even about different therapeutic interventions.”

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For example, patients with mild cognitive impairment could struggle to manage their medications or other chronic conditions. If those issues go unrecognized, they can lead to avoidable events such as hospital admissions, which can be disorienting and can worsen overall health.

Cerdá added that while disease-modifying treatments targeting amyloid plaques are advancing, more evidence is needed to determine their impact on long-term clinical outcomes. For now, earlier diagnosis and supportive care remain key to improving patient health.

Looking ahead, James Ellison, M.D., M.P.H., a geriatric psychiatrist at Jefferson Health, said dementia care could shift toward helping patients remain at home longer with stronger support systems in place.

“One of the most important goals is extending the duration of home care, because that’s less costly and less disruptive for a family and more comfortable for a patient,” Ellison said. “We need to train family caregivers, make them feel valued and supported, and, in some cases, insurance will even pay them to be caregivers at home.”

Ellison added that advances in data analytics and artificial intelligence could help identify at-risk patients earlier by analyzing electronic health records and claims data. Combined with emerging treatments, these tools could allow clinicians to tailor care more efficiently.

Ellison stressed that newer disease-modifying therapies are also changing the landscape, making accurate diagnosis and early detection much more important for guiding treatment decisions.