If you have a parent or partner with early Alzheimer's, you have probably heard about the first drugs that can slow the disease. For many families the news has felt like a long awaited turning point. The hope now sits next to a harder question.
Who is actually getting these treatments?
A new study from Michigan Medicine, published in the journal Neurology, finds that race, ethnicity, overall health and social disadvantage shape who receives the new anti-amyloid drugs.
Among more than one million US adults with mild cognitive impairment or dementia, Black adults had 86 percent lower odds of getting the medication than non-Hispanic white adults. Hispanic adults had 79 percent lower odds.
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Patients facing greater disadvantage, measured by income, education, housing and neighborhood resources, were nearly half as likely to receive the drugs. The researchers tracked 2,427 treated patients and compared them with similar untreated patients.
Other illnesses carried alongside the memory diagnosis also made treatment less likely.
What the drugs are and who is eligible
The treatments in question are lecanemab, sold as Leqembi by Eisai and Biogen, and donanemab, sold as Kisunla by Eli Lilly. They are the first drugs approved by the Food and Drug Administration to slow Alzheimer's by clearing the sticky amyloid plaques that build up in the brain.
According to the Alzheimer's Association, lecanemab is approved only for people with mild cognitive impairment or mild dementia caused by Alzheimer's.
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It can only be prescribed after a scan or spinal fluid test confirms the plaques are present.
The drugs are not a cure. In the trials they slowed decline, giving patients more time in the earlier stages. They also come with real demands. Lecanemab's list price is about $26,500 a year.
Patients need regular MRI monitoring for a side effect called ARIA, meaning amyloid related imaging abnormalities. These are mostly small brain swellings or tiny bleeds that show up on the scan.
Where the gap seems to open
The Michigan researchers found one hopeful signal. Once treatment began, patients took their medication at similar rates regardless of race or ethnicity. The gap is not about staying on the drug. It is about getting on it in the first place.
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Co-first author Melissa Elafros, a neurologist at the University of Michigan Medical School, said the pattern raises serious questions. The concern is how patients are identified, evaluated and ultimately selected for treatment.
Senior author Brian C. Callaghan said efforts should focus on helping eligible patients start therapy rather than on adherence afterward.
The study does not spell out every reason the gap opens so early. The path to one of these drugs is long. A patient needs a specialist, a confirmed Alzheimer's diagnosis with a biomarker test, access to an infusion or injection clinic, and insurance coverage.
Each step is a filter, and Medicare only pays for the drug when the prescribing doctor enters the patient into a national registry.
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The findings land on top of a larger imbalance.
Older Black Americans are about twice as likely to have Alzheimer's or another dementia as older white Americans. Older Hispanic Americans are about one and a half times as likely, according to the Alzheimer's Association's 2026 Facts and Figures report.
An estimated 7.4 million Americans age 65 and older are living with Alzheimer's in 2026.
What families can do now
For a family wondering whether a loved one is a candidate, the first step is a referral to a neurologist or memory clinic that can order the biomarker tests the FDA requires. Ask the doctor directly whether lecanemab or donanemab is an option. If the answer is no, ask why.
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If the clinic does not offer the drugs, ask for a referral to one that does.
Insurance is a separate question. Coverage for these drugs is tied to the registry the prescribing physician must enroll the patient in.
If a doctor says the drug is appropriate, families can ask whether the practice participates and where the closest participating center is if not.
Patients with memory concerns, and families noticing a change in a parent, should talk with a doctor sooner rather than later. The anti-amyloid drugs only work in the early stages. Eligibility narrows quickly once the disease advances.
This article is made and published by Jesper Bengtson, who may have used AI in the preparation.