GSA Report Highlights Brain Health Breakthroughs and Challenges for Primary Care Providers

“Understanding Breakthroughs in Brain Health: Top 10 Articles of 2025” — the latest “Top 10” report in the Gerontological Society of America’s Insights & Implications in Gerontology series — presents a curated collection of the year’s most impactful research on cognitive decline, dementia detection, and brain health across the lifespan, with a focus on actionable insights for primary care providers.

Alzheimer’s disease (AD) affects approximately 7.2 million Americans aged 65 and older, representing roughly 11% of that population, and its prevalence is rising as the country ages. The economic toll is substantial: health and long-term care costs for people living with AD and other dementias reached an estimated $384 billion in 2025, with an additional $413 billion in care provided by roughly 12 million unpaid caregivers. Despite these staggering numbers, AD remains significantly underdiagnosed, particularly in its earliest, most treatable stages.

"Primary care is where most people with dementia are first diagnosed and where they receive most of their care", said Soo Borson, MD, co-lead of the BOLD Public Health Center of Excellence on Early Detection of Dementia and a professor at the Keck School of Medicine at the University of Southern California, who served on the report's expert advisory panel. “This collection of research gives clinicians the evidence they need to act earlier, more confidently, and more effectively for their patients.”

The report underscores the critical and expanding role of primary care providers in the early detection and management of cognitive decline. Research included in the report found that the average time from symptom onset to a dementia diagnosis is 3.5 years, a delay that can cost patients access to disease-modifying therapies and timely care planning. With only 8–11% of mild cognitive impairment cases identified early, and underdiagnosis disproportionately affecting Black and Hispanic populations, the need for systematic change in primary care practice is made clear in the report.

Advances in diagnostic technology are helping to close this gap. Blood-based biomarker tests, now increasingly available to primary care providers, offer a less invasive and more accessible means of detecting AD pathology compared with traditional PET imaging or cerebrospinal fluid analysis. Digital cognitive assessments are also emerging as practical tools for streamlining screenings, with the potential to integrate directly into electronic health records and reduce administrative burden on clinical staff.

The report also highlights the growing body of evidence linking modifiable lifestyle factors to brain health outcomes. The landmark US POINTER randomized clinical trial, among the studies featured, demonstrated that structured, multidomain lifestyle interventions addressing exercise, diet, cognitive engagement, and social activity produced significantly greater cognitive benefits than self-guided approaches. Additional research featured in the report connects sleep quality, oral health, and food security to measurable differences in the risk of cognitive decline and dementia.

“Primary care providers are uniquely positioned to identify cognitive changes early and connect patients with the resources and interventions that can make a real difference. Incorporating cognitive screenings into routine visits, and normalizing conversations about brain health, are practical, high-impact steps that every practice can take,” said Anna Pendrey, MD, DABOM, an assistant professor at the Indiana University School of Medicine, who also served on the report's expert advisory panel.

The report also draws attention to a troubling gap in care support following a dementia diagnosis. Research shows that while people with dementia are more likely to receive assistance after diagnosis, their disability needs increase faster than the support provided, leaving a widening shortfall, particularly for instrumental activities of daily living such as managing medications or finances. The report calls on primary care teams to strengthen care coordination, conduct regular assessments of patients’ functional needs, and connect individuals and families with appropriate community resources.

Other members of the expert advisory panel include Frederick Ketchum, MD, PhD, of the University of Wisconsin School of Medicine and Public Health; Kemi Reeves, DNP, MBA, GNP-BC, of the David Geffen School of Medicine at UCLA; and Mike Splaine, principal of Splaine Consulting. Lilly provided support for this report.

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The Gerontological Society of America (GSA), founded in 1945, is the oldest and largest interdisciplinary organization focused on aging. It serves more than 6,000 members in over 50 countries. GSA’s vision, meaningful lives as we age, is supported by its mission to foster excellence, innovation, and collaboration to advance aging research, education, practice, and policy. GSA is home to the National Academy on an Aging Society (a nonpartisan public policy institute) and the National Center to Reframe Aging.