Startups Eye $2.8 Trillion Dementia Challenge as Healthspan Gap Widens

While life expectancy has risen rapidly across the developing world, dementia has become a key contributor to poor health, leading to a gap between lifespan and “healthspan.” However new tools, such as AI-powered screenings, blood-based biomarker tests, and connected-home care technologies could help bridge the divide.

These are the findings of a new report by the Milken Institute that warns the disease will cost the world $2.8 trillion a year by 2030 without faster action. According to the report, nearly 140 drugs are currently in development for Alzheimer’s, but beyond addressing the condition therapeutically, many opportunities exist for companies providing diagnostic tests, brain health apps and technologies to help caregivers and physicians track patients.

“Growing evidence finds that people spend a decade or more in poor health, the ‘marginal decade’ toward the end of life, with women experiencing a longer healthspan-lifespan gap than men,” the Milken report said. “Now, researchers, medical professionals, governments, and public health institutions should focus on ensuring those additional years are lived in good health.”

Prevention, Detection and Diagnosis of Alzheimer’s

Nearly half of dementia cases could be prevented or delayed by addressing 14 known risk factors, according to the 2024 Lancet Commission. These risks include hearing loss, smoking, depression, social isolation, and unmanaged high blood pressure.

The Milken Institute report points to the “five-finger” approach to reducing these Alzheimer’s risks: healthy diet, regular physical activity, mental stimulation, social engagement, and cardiovascular health.

Early detection of dementia could permit some interventions to help delay disease progression, yet such diagnoses remains rare. In the U.S., only about 16 percent of adults older than 65 report receiving a cognitive assessment during a routine primary care visit, according to the report. In the United Kingdom, diagnosis rates are higher, but fewer than half of referrals to memory clinics include an initial assessment by a primary care provider. The issue is particularly acute in rural areas, where staffing shortages contribute to the lack of testing.

Despite these challenges, breakthrough technologies are beginning to address the diagnostic gap. The Milken report highlights blood-based biomarker tests, digital cognitive assessments, and AI systems that can be integrated into primary care offices. Telemedicine programs and training for non-specialist clinicians, including community health workers, are also being used to expand access and speed up diagnosis.

Investors Seeing Potential of Global Alzheimer's Disease Diagnostics

This technological progress hasn't gone unnoticed by investors. The global Alzheimer's disease diagnostics market is valued at $10 billion and is projected to grow at 11 percent annually over the next decade, according to analyst estimates.

This growth is fueled by new product launches and increased adoption of early screening tools that expand the Alzheimer’s patient population. Companies are also advancing digital cognitive testing to improve participant recruitment for clinical trials and track disease progression remotely, while expanding access.

One company already positioning itself to tap this growing market is Sunbird Bio, which is developing what could be the first blood test able to detect multiple protein aggregates linked to major neurodegenerative diseases, including Alzheimer’s and Parkinson’s. By identifying co-pathologies through a simple, scalable blood draw, the company aims to accelerate clinical trial recruitment and expand access to early, accurate diagnosis.

Another growing market in this space is the demand for dementia care apps, currently valued at $31 billion with a 7 percent annual growth rate for the next 10 years. These programs offer cognitive exercises, daily task reminders, safety monitoring and caregiver support. They’re gaining traction with patients, providers and caregivers along with wider awareness of their benefits.

Targeted Treatments Take on Amyloid

Drug development for Alzheimer’s disease and other dementias is moving beyond the long-standing focus on amyloid plaques, with nearly 80 percent of active clinical trials targeting other mechanisms, including inflammation, tau protein buildup and changes in neurotransmitter receptors, the Milken report said.

One example is the work of Aggregate Biosciences, which is developing novel diagnostics and therapeutics to detect and eliminate amyloid aggregates in the blood, aiming to change the way amyloid-related diseases like Alzheimer’s and certain forms of type 2 diabetes are diagnosed and treated.

Researchers are also mapping how amyloid processes may combine or overlap to cause different forms of dementia, which could lead to precision treatments tailored to an individual’s specific pathology.

Economic models suggest the potential impact is substantial. In one scenario, a therapy that delays Alzheimer’s onset by five years could reduce U.S. prevalence by 25 percent in 2050 and save $3.1 trillion in cumulative costs. Advances in biomarkers and companion diagnostics are expected to help identify patients most likely to benefit from emerging therapies.

The stakes extend beyond individual health to economic sustainability, according to Milken.

“By fostering advancements in biotechnology, healthcare and social care delivery, and risk-reducing lifestyles, longevity investing can catalyze the transformation needed to ensure that thriving – not just surviving – becomes the hallmark of our era,” the report said.