Investing in Alzheimer's Solutions

Executive Summary

Advances in modern medicine have enabled adults to live longer, but this trend has been accompanied by increases in aging-related diseases. The U.S. healthcare system is struggling to keep up with the increasing number of older adults and the costs associated with their care. Neurodegenerative diseases are increasingly common and Alzheimer’s disease is one of the most nefarious. Alzheimer’s is the leading cause of dementia and death around the world. Since its first diagnosis in the early 20th century, experts are still unpacking the science behind how Alzheimer’s originates and progresses.

Pharmaceutical companies and philanthropic organizations have largely driven investments in potential Alzheimer’s treatments, but private and venture investors are increasing their involvement. For-profit investors have gained experience in advancing management technologies and senior care. And while capital slowly flows toward the Alzheimer’s, there is significant potential for more. The extent to which Alzheimer’s will affect the U.S. population is astronomical but sufficient guidance is necessary for investors seeking to make strategic investments.

This report highlights some of the most promising industries, strategies, and companies in the Alzheimer’s sector based on the latest scientific and investment research. To reflect the various stages at which investors can intervene, the sector was broken down into four major areas—prevention, diagnosis, management, and treatment.

Slowing the onset of dementia by five years would save the U.S. healthcare system billions of dollars every year. Simple behaviors like cognitive and social engagement can delay an onset of Alzheimer’s. To meet this solution, entrepreneurs have developed tools that increase patients’ cognitive activity, such as “brain games” and virtual reality. Investors can expect to see more clinically validated tools moving forward that improve cognitive functioning in older adults, potentially staving off neurodegeneration.

Alzheimer’s has typically been diagnosed using expensive tests like PET scans, but not all seniors have access to imaging facilities. In the meantime, the medical community has developed blood tests that are comparably accurate and can be added to routine blood work. While it might take time for these tests to become price competitive and covered by insurers, entrepreneurs can leverage technology to detect early clues of dementia through changes in speech, cognition, heart rate, and other basic physical traits. Smart diagnostic devices will likely become part of most clinical practices in the coming years.

Management solutions refer to companies that help patients “age in place.” Alzheimer’s patients have specific needs, particularly as the disease worsens. They often suffer from emotional issues and forget to do basic tasks. Family members serve as unpaid caregivers and as patients require more around-the-clock care, their loved ones are increasingly burdened. Technologies that detect whether a patient wanders off or takes their medicine can be especially valuable. Digital therapeutics that help patients engage with their environments and experience social connection can significantly improve quality of life.

An Alzheimer’s cure would be a financial blockbuster. But the market’s historical failures deter many investors. Why has a cure been so elusive? The time required to observe changes in the brain is extensive, and by the time they are detectable, patients are already on the path to dementia. As a result, scientists are keen to discover how Alzheimer’s changes the body over time. This requires an examination of validated biomarkers or neurodegenerative indicators. One of the key efforts by Alzheimer’s stakeholders, such as the Alzheimer’s Drug Discovery Foundation, is to determine a standardized set of biomarkers that can be used to track the disease long before a patient has it. This can help create better clinical trials where patients are carefully segmented and drugs are tested on their ability to reverse the disease much earlier on.

Innovation among disease-modifying therapeutics abounds. Amyloid and tau-based drug candidates dominated the industry for years, but after many expensive clinical trials, the results have not produced any approved drugs. Consequently, scientists have increasingly turned to new drugs based on alternative hypotheses. Some include “the immune hypothesis,” “the blood brain barrier,” and “epigenetic modification.” Scientists have found that brain and inflammatory diseases are highly related. Potential cures for Alzheimer’s could be tied to other diseases like schizophrenia, epilepsy, or even gingivitis. The implications of finding an Alzheimer’s cure extend far beyond one disease. Non-pharmacological solutions, such as those involving electrical stimulation and behavioral therapeutics are also up-and-coming.

The financial burden of clinical trials poses a significant challenge to budding biotech companies. Investors are encouraged to explore the science behind new Alzheimer’s drugs, and help them realize their potential. Promising developments in the treatment market didn’t exist 15 years ago. Despite new and innovative treatment approaches, investors who were previously burned by failed clinical trials for amyloid drug candidates might need extra persuasion or more compelling preclinical and early stage clinical results before investing in this market again.

The Alzheimer’s market is complex, but the opportunity for impact is too sizable to ignore. An influx of capital is urgently needed so the field can evolve and provide greater clarity as to which investment opportunities are the most promising. Emerging frameworks are better able to quantify the value of new solutions to patients and society in terms of public health and costs. When equipped with key insights, investors can significantly improve the lives of patients and their families and reduce billions in U.S. healthcare expenditures.