Improving Alzheimer’s research and care for Veterans

About 300,000 Veterans are believed to have Alzheimer’s disease and related dementias, and it’s estimated that as many as 70% of those individuals are undiagnosed—a rate much higher than the general population. With the U.S. Department of Veterans Affairs expecting the number of patients with dementia to increase 22% by 2033, action is needed to expand access to dementia care for Veterans. 

With this urgent need in mind, Guidehouse partnered with the National Association of Veterans’ Research and Education Foundations (NAVREF) to host “State of the Science: Advancing Alzheimer’s Research for Veterans,” our second co-hosted event.  

Held in Arlington, Virginia, the summit brought together leaders from VA and other federal agencies, academia, and additional organizations across the healthcare industry to explore how a collaborative, data-led approach to treatment and care coordination can inform research and improve Veteran outcomes. 

VA’s scale and data: A unique research advantage 

VA is uniquely positioned to advance Alzheimer’s research at a national level. It oversees the largest integrated health system in the U.S.—nearly 1,400 facilities serving more than 9 million Veterans—and has access to longitudinal data that spans the full patient lifecycle. This breadth enables researchers to study disease progression, treatment response, and comorbidities in ways that are difficult to replicate elsewhere.

Beyond size, the highly engaged Veteran population—often motivated by a sense of service—supports strong participation and retention in clinical research. That reinforces VA’s role as a powerful platform for innovation and real-world evidence generation. 

Merging care delivery and research earlier in the disease journey 

A central theme throughout the summit was the shift from managing Alzheimer’s in later stages to intervening much earlier in the disease course. The emergence of disease-modifying therapies is accelerating this transition, but access remains uneven due to strict eligibility requirements, imaging constraints, and patient complexity.  

Poor utilization also suggests unmet care needs or a lack of awareness about VA services. Only about 35% of VA dementia patients participate in the agency’s Geriatrics and Extended Care Program, which provides services to older, frail, chronically ill patients and their caregivers. To fully realize the potential of new therapies and research, summit participants emphasized the need for organizations to integrate clinical care, support services, and research more effectively. This will create clearer pathways from diagnosis to trial participation, embedding research opportunities into routine care and service delivery. 

Regional innovation as a blueprint for national scale 

Dementia care in the VA health system in Charleston, SC, is a strong example of how local VA health systems can build an end-to-end pipeline for Alzheimer’s care and research. Through its Rapid Access Memory Screening clinic, the health system captures most patients at an early stage. Those who screen positive are enrolled in the Alzheimer’s Disease Registry Initiative, undergo biomarker testing, and are incorporated into cohorts that can then be enrolled in clinical trials or treatment pathways. 

This site-level process offers a personalized experience, improves access to care, and gives patients the best possible chance at advanced, targeted treatment. The VA Charleston model offers a pragmatic blueprint for scaling these capabilities across VA and reducing variability between sites. 

Public-private partnerships: Essential but operationally complex 

Collaboration between VA, industry, academia, and nonprofits is foundational to advancing Alzheimer’s research, with NAVREF and its affiliated nonprofit research corporations (NPCs) serving as key enablers. Across roughly 78 NPCs nationwide, these organizations help channel an estimated $350 million to $360 million in annual external research funding into VA while supporting contracting, staffing, procurement, and multi-site trials. 

Still, speakers at the event noted that execution remains slowed by complex contracting processes, fragmented coordination, and uneven readiness across VA sites. Continued progress will depend on simplifying pathways and strengthening alignment across partners. 

Designing Alzheimer’s research around Veterans and caregivers 

The event underscored that successful Alzheimer’s research depends not only on scientific infrastructure but also on practical support for the people participating in it. Veterans may be highly motivated to join clinical trials, but caregivers often carry the operational burden of participation. They provide an estimated 31 hours of unpaid care each week while also managing transportation, scheduling, long visits, food access, Wi-Fi needs, and respite. 

A Veteran’s support system—or lack thereof—can be the determining factor for whether they’re able to enroll and remain engaged or complete a study. Building more flexible, caregiver-informed research models can improve recruitment and retention while making participation more realistic for Veterans and families. 

5 steps government and life sciences leaders can take to accelerate dementia care 

Federal and local VA leaders can build on these discussions by focusing on five practical steps to expand access, strengthen partnerships, and scale proven models across VA:  

1. Expand early detection by embedding screening and diagnostic tools into routine care and using electronic health record data to identify trial-eligible patients.  
2. Scale proven site models like VA Charleston by investing in standardized infrastructure and trial-ready cohorts across VA. 
3. Streamline partnerships through simplified contracting mechanisms, shared templates, and earlier collaboration during study design. 
4. Use AI and digital tools to improve trial recruitment, enable remote or hybrid participation, and accelerate real-world evidence generation. 
5. Partner with federal and local counterparts to build more consistent systemwide capabilities that support multi-site clinical trials and reduce variation across facilities. 

The bottom-line takeaway that emerged from the summit was clear. By aligning care, research, data, and partnerships around the needs of Veterans and caregivers, government and life sciences leaders can help move dementia innovation from isolated success stories to sustained national impact.