利用创新改善美国农村阿尔茨海默氏症的诊断和护理（英）

SANDRA BARBOSU AND LILA TROLLIP| MARCH 2026 Rural communities face structural barriers to diagnosing Alzheimer’s early, which increasesburdens on patients and caregivers while raising health-care costs. Policymakers should addressthe problem by expanding provider training and accelerating scalable diagnostic technologies. KEY TAKEAWAYS Rural communities face heightened Alzheimer’s risk due to older populationdemographics, compounded by structural, geographic, and financial barriers to care.Delayed diagnosis increases downstream health-care spending, intensifies caregiverburden, and contributes to workforce losses in already fragile rural economies.New technological innovations—including blood-based biomarkers, digital cognitivescreening tools, and FDA-approved therapeutics—offer solutions that can expand accessand reduce rural health disparities, but they require policy changes to scale.Targeted federal and state policies are essential to improve timely Alzheimer’s diagnosisin rural America, including strengthening the rural health workforce, accelerating accessto innovative diagnostics and treatments, and supporting caregivers. CONTENTS Key Takeaways................................................................................................................... 1Introduction....................................................................................................................... 2Challenges in Rural America................................................................................................ 4Economic Burden of Alzheimer’s in Rural Areas .................................................................... 6Diagnostic Innovations...................................................................................................... 10Policy Recommendations .................................................................................................. 13 itif.org Conclusion ...................................................................................................................... 16Endnotes......................................................................................................................... 17 INTRODUCTION Alzheimer’s disease represents one of the most pressing and costly public health challengesfacing the United States. As the population ages, the prevalence of Alzheimer’s continues to risesharply, with millions of Americans already affected, and projections indicating substantialgrowth in the coming decades. Despite more than a century of scientific inquiry, Alzheimer’sremains difficult to diagnose early, with patients often waiting years between the onset ofsymptoms and formal diagnosis. These delays limit access to timely care, impede planning andintervention, and contribute to a growing clinical and economic burden borne by patients,caregivers, health systems, and society at large. The consequences of delayed and inequitable diagnosis are particularly severe in rural America.Rural populations are older on average, are aging more rapidly, and face shrinking caregivingworkforces—factors that increase both the risk and impact of Alzheimer’s disease. Yet, thesecommunities frequently lack access to specialized clinicians and diagnostic infrastructure—suchas positron emission topography (PET) imaging and advanced biomarker testing—thatincreasingly define the standard of Alzheimer’s care. As a result, rural residents are more likely tobe diagnosed later, underdiagnosed entirely, or geographically excluded from access to emergingtherapies and clinical trials. Addressing Alzheimer’s disease therefore requires not onlyadvancements in biomedical science but also policy action to modernize diagnostic pathwaysand expand access to scalable, accessible detection tools deployable within primary caresettings—particularly for underserved rural populations. Status and Prevalence of Alzheimer’s Disease Due to an aging population, America is facing an unprecedented Alzheimer’s crisis. As of themost recent statistics, published in 2024, more than 6 million Americans are living withAlzheimer’s disease, and some projections suggest that this number could more than double tonearly 14 million by 2060.1Alzheimer’s is currently the seventh-leading cause of death in theUnited States, underscoring both its clinical severity and its growing public-health impact.2 The number of people with Alzheimer’s disease increased drastically from 1990 to 2019, morethan doubling from 2.88 million to 6 million, largely reflecting population aging and longer lifeexpectancy—a testament to the strengths of the U.S. health-care system. Yet, despite more thana century of research since Alzheimer’s disease was first described in 1910, patients still wait anaverage of three years from symptom onset to formal diagnosis.3 Furthermore, disability-adjusted life years (DALYs) due to Alzheimer’s disease have more thandoubled since 2000, increasing from 11.8 million to 32.6 million. DALYs