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

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

Team L&M

Alzheimer’s early detection is becoming a priority in India as dementia cases rise and a new treatment reaches the market, yet access to diagnosis remains uneven . 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. Alzheimer’s early detection means spotting memory and thinking changes at the mild stage, before daily life is badly affected. India has an estimated 8.8 million people aged 60 and above living with dementia. The newly approved drug lecanemab is meant only for early disease with confirmed amyloid, so timely diagnosis decides who may benefit.

Why Alzheimer’s Early Detection Matters in India

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.Mild cognitive impairment is often the stage at which families first notice repeated forgetfulness, and it is the point where evaluation matters most.

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.

Dementia in India: What the Numbers Show

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. Dementia in India is expected to rise sharply, with one projection putting cases at 16.9 million by 2036 if current prevalence holds.

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.

Who Can Use the New Alzheimer’s Drug

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.Lecanemab (Leqembi) is approved by CDSCO only for early-stage disease with confirmed amyloid, so it is not an option for everyone.

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.”

Alongside medical care, many families also look at how physiotherapy can help restore movement, confidence and independence for older relatives.

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. Alzheimer’s early detection will decide how many families can actually benefit from new treatments, which makes access to memory clinics and testing as important as the drugs themselves.

FAQ

What is Alzheimer’s early detection?
It means identifying memory and thinking changes at a mild stage, usually through a doctor’s assessment, cognitive tests and, where needed, scans or biomarker tests. Early identification gives families more time to plan care.

Who can take lecanemab in India?
As reported at launch, CDSCO has approved lecanemab for mild cognitive impairment or mild dementia due to Alzheimer’s disease, with amyloid confirmed by a biomarker test. It is given by intravenous infusion, and only a specialist can decide if it is suitable.

How many people have dementia in India?
One study-based estimate puts the figure at about 8.8 million people aged 60 and above, or 7.4% of that age group. Projections suggest it could reach 16.9 million by 2036 if prevalence stays the same.

When should someone see a doctor about memory problems?
If forgetfulness, confusion or difficulty with routine tasks keeps getting worse, a neurologist or geriatric specialist can assess it. Occasional forgetfulness is common with age and does not always point to Alzheimer’s.

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