Dementia, more than a diagnosis and drugs: perspectives from primary care on the new therapeutic era for Alzheimer’s disease

The emergence of anti-amyloid therapies and blood-based biomarkers is transforming the diagnosis and treatment of Alzheimer's disease. In this Viewpoint, as academic primary care physicians, we critically examine how these new diagnostic tools and therapies might drive earlier diagnosis of dementia in primary care and reshape diagnostic pathways, while raising ethical, legal, and social concerns, including high costs, clinical risks, and inequities in access. We explore whether the novel tools will simplify or further complicate the complex clinical reasoning in primary care dementia diagnosis. We emphasise the need to integrate primary care into these new treatment pathways while optimising care for all people with dementia to mitigate worsening health disparities and ensure holistic dementia care, encompassing preventive strategies, post-diagnostic support, early diagnosis, and curative treatments.