The Earlier You Know, the More You Can Do

Most families wait years to put a name to what they're seeing. Here's what an earlier answer actually buys you now — and a calm way to start.

It took us more than a year to get an answer

When something started to change in my wife Lori, the hardest part wasn't the symptoms. It was the not-knowing.

The signs were scattered: bills paid twice or not at all, a melted-down afternoon after she got lost driving to a doctor's appointment, a hot griddle left burning in an empty kitchen. This was a woman who repaired hospital lab equipment for a living — and she hid what was happening as long as she could, the way so many people do. I wrote everything down, not because I had a plan, but because I was scared and it was all I could think to do.

Getting an answer took dozens of tests across a full year, and three different neurologists before we found one who could actually help. On March 3, 2016, we finally heard the word out loud: Alzheimer's. Lori was in her forties.

This September, World Alzheimer's Month carries a theme I wish I could send back in time to myself: “The Earlier You Know, The More You Can Do: A Dementia Diagnosis Matters.” Having lived both halves of that sentence, I want to walk through what it really means.

Why families wait — and what the wait costs

Our year of searching wasn't unusual. If anything, it was fast.

A 2025 analysis of more than 30,000 patients found that families wait an average of 3.5 years between first symptoms and a diagnosis — 4.1 years when the disease starts young, as it did for Lori. Worldwide, Alzheimer's Disease International estimates that as many as three-quarters of people living with dementia have never received a formal diagnosis at all.

The reasons are human ones. We explain things away, because everyone forgets a name sometimes. The person who is struggling often works hard to cover it. And underneath it all sits the quiet belief that a diagnosis changes nothing, so why chase one? Even now, only about 14 percent of Americans say they've talked with their doctor about memory or brain health — while about two-thirds say they'd want their doctor's guidance.

That belief — a diagnosis changes nothing — deserves a hard look, because in 2026 it is simply no longer true.

What an earlier answer actually buys you now

For the first time, the earliest window is when medicine has the most to offer — not the least.

• Diagnosis itself has gotten easier. In May 2025 the FDA cleared the first blood test to help identify Alzheimer's-related changes, for adults 50 and older who already have symptoms and are being evaluated in a specialist setting. In October 2025 a second blood test was cleared — the first for use in primary care. What once required a specialized PET scan or a spinal tap can now often start with a blood draw.
• The approved disease-modifying treatments are early-stage only. Lecanemab (Leqembi, 2023) and donanemab (Kisunla, 2024) are meant to be started at mild cognitive impairment or mild dementia. Their benefits are modest and they carry real risks that require monitoring — but families who wait years to seek answers can wait themselves right out of eligibility.
• An evaluation can catch the imposters. Thyroid disease, medication interactions, depression, sleep disorders, vitamin B12 deficiency and delirium can all mimic dementia — and many of them are treatable or reversible.
• Early diagnosis opens the door to clinical trials, which increasingly recruit people in the earliest stages.
• And the part no prescription touches: time while your person can still take part. Powers of attorney, advance directives, the “what matters most to you” conversations, decisions about driving and safety — all of it is lighter when it's done together. Research on caregiver support points the same direction: families who get counseling and support early do better, longer, and are able to keep their person at home longer.

Lori understood what was coming while she could still say what she wanted. That is why the years that followed — the road trips, the fifty thousand miles on the truck with no destination — were ours to spend on purpose. The diagnosis didn't take those years from us. It gave them to us.

Normal aging, or something more?

The line between the two is about pattern and function, not any single moment.

Normal aging is occasional and inconvenient: the name that comes to you an hour later, the glasses in the wrong room. Changes worth a conversation with a doctor tend to be different in two ways — they get worse over months rather than staying level, and they start to interfere with everyday function: bills, medications, familiar routes, recipes cooked for thirty years.

One forgotten appointment is a Tuesday. A pattern of slipping function is a signal.

A calm way to start: observe before you alarm

You don't have to choose between ignoring your worry and marching a resistant parent to a neurologist.

There is a middle step, and it's the one I wish someone had handed me: structured observation. Watch specific, everyday abilities over a few weeks — calmly, privately, without turning your home into a clinic. Not “is her memory bad,” but: can she still manage her own medications? Follow a recipe she has cooked for thirty years? Get to a familiar place and back? Handle a bill from start to finish? Track those, with dates, and a pattern either appears or it doesn't. Our Cognitive Observation Protocol is the structured version of exactly this — a no-quizzing week of ordinary activities that rolls up into a green, yellow or red answer. It's a member tool inside The Compass.

If everything reads green, you've bought yourself peace of mind. If a pattern emerges, you walk into the doctor's office with dated, concrete observations instead of “something seems off” — which is exactly the kind of history that helps a doctor take the concern seriously and move faster.

If this September is your nudge

World Alzheimer's Day is September 21. If someone has been on your mind while you read this, let that be your reason.

Pick one small thing. Start a quiet observation log. Book the regular checkup and mention the word “memory” while you're there. Forward this to the sibling who has been noticing the same things you have.

Waiting feels like kindness — I know, I waited too. But the earlier you know, the more you can do. And more than anything else, what you get is time.