Alzheimer’s Early Detection Becomes Critical as India Faces Access Gaps

Team L&M

As dementia cases rise sharply across India’s ageing population, doctors say the country’s ability to diagnose Alzheimer’s disease early warning signs and treat early is crucial. The arrival of new drugs alone won’t help. Knowing Alzheimer’s disease early warning signs and beginning treatment early will let us know if patients actually benefit from recent medical advances.

The Rising Need for Early Alzheimer’s Detection

An estimated 8.8 million Indians above 60 are currently living with dementia, with Alzheimer’s disease accounting for close to two-thirds of these cases. Dementia cases India 2036 projection is nearly double of this i.e 16.9 million. The World Alzheimer’s Day is observed on September 21 every year t spread awareness about the disease.

For nearly three decades, treatment options were limited to drugs that eased symptoms such as memory loss and behavioural changes without altering the underlying disease.

That changed this year when lecanemab, sold as LEQEMBI, became India’s first approved disease-modifying therapy for Alzheimer’s, following clearance from the Central Drugs Standard Control Organisation. Unlike earlier drugs, it is designed to act on the biological process driving the disease rather than only its downstream symptoms.

Dr. Madhukar Bharadwaj, Director & HOD Neurology, Aakash Healthcare said the approval has changed a conversation doctors have had with anxious families for years. “For years, families have asked us the same question — can we do anything to actually slow this down, not just manage it. Until now, our honest answer was limited. With lecanemab now available in India, that conversation is finally beginning to change, even if it is only for patients we catch early enough,” he said.

India’s Access Gap Could Limit New Treatment

Doctors say this limitation is central to how doctors can use the drug.Dr. Madhukar Bharadwaj explains that doctors can use lecanemab only for early-stage disease. Doctors can prescribe it to patients with mild cognitive impairment or mild dementia, but not to those with more advanced disease.

Before treatment, doctors must confirm amyloid pathology through cerebrospinal fluid analysis or blood-based biomarker testing. This makes early diagnosis more important than ever. Doctors can no longer simply ask patients with mild forgetfulness to wait and watch. If the disease progresses too far, patients may no longer qualify for disease-modifying treatment.

Doctors say primary care systems must improve referrals, conduct cognitive screening at the first point of contact, and strengthen coordination among general physicians, geriatricians and neurologists—areas where most centres in India still lack adequate resources.

The Access Gap in Early Alzheimer’s Care

Dr. Neha Kapoor, Associate Director and HOD Neurology, Asian Hospital which treats elderly patients from both urban and semi-urban areas, said access remains the bigger obstacle. “People generally assume slower memory is just old age, something to live with, not something to check. By the time they walk into a hospital, it has already progressed. The key lies in ensuring that there is medical help available in rural and semi-urban areas also for early detection and treatment,” Dr. Neha Kapoor said.

Diagnostic Infrastructure Remains Limited

That access gap, doctors note, is largely a geographic one. Dr. Rajas Deshpande, Consultant and Director – Neurology, Jupiter Hospital said, “The infrastructure required for lecanemab — CSF testing, PET imaging, MRI monitoring — currently exists in only a handful of Indian metros. In smaller towns, patients may have to travel for hours to reach a neurologist, while doctors often overlook early memory loss instead of investigating it.

Dr Deshpande described early intervention as a logistical challenge as much as a medical one. “We talk about early intervention as if it is purely a medical decision. In reality, it is a logistics problem first — can the patient reach diagnostic infrastructure before the disease moves past the stage where this treatment can help them.”

Looking Beyond Alzheimer’s to Healthy Ageing

Doctors also flagged a broader pattern of ageing-related health concerns going unaddressed in isolation from one another. Dr. Vineet Malhotra Senior Consultant- Urology & Andrology VNA Hopsital pointed to men’s sexual health as one such overlooked area. “Vascular health, hormonal balance, diabetes — these influence both brain function and sexual health in ageing men, yet patients almost never bring up the two together, and doctors don’t always ask. If we are serious about early-stage screening for conditions like Alzheimer’s, we also need men to feel comfortable raising every quiet symptom, not just the ones that feel socially acceptable to mention.”

Doctors broadly agreed that closing India’s diagnostic gap will require community-level cognitive screening, training for primary care teams to recognise early warning signs, and sustained public awareness campaigns in regional languages