Phil Coticelli Shares a Message of Hope About Alzheimer’s
As executive director of the Alzheimer’s Policy Working Group, Phil Coticelli spends his days talking to the country’s top Alzheimer’s researchers, clinicians, and policymakers.
In this episode, he explains “the wall” he sees splitting Alzheimer’s care in two, why critical blood tests aren’t reaching enough patients, and what early detection could save patients throughout the nation.
In This Episode:
Your Host: Emily Kaplan
Our Guest:
Phil Coticelli, Executive Director of the Alzheimer’s Policy Working Group and publisher of Solving Alzheimer’s on Substack
This Episode Explores:
- What does Phil Coticelli mean by “the wall” in Alzheimer’s care?
- Why aren’t more patients getting blood tests that could catch Alzheimer’s early?
- Should cognitive screening be part of Medicare’s annual wellness visit?
- What could early Alzheimer’s detection save the healthcare system?
- How did Coticelli’s own family shape his focus on brain health?
What Is “The Wall” Between Prevention and Alzheimer’s Medicine?
Phil Coticelli spent 18 months interviewing doctors, patients, caregivers, and researchers across the Alzheimer’s field. He came away describing a wall running through the middle of healthcare. On one side is prevention: diet, exercise, sleep, and community. On the other is the traditional medical system, built around peer-reviewed research and incremental drug development. The two sides, he says, rarely collaborate.
Coticelli argues that early detection is the bridge that connects them, since a diagnosis gives people a reason to act on both fronts at once, changing their lifestyle while also pursuing treatment.
Why Blood Tests for Alzheimer’s Aren’t Reaching Enough Patients
Coticelli notes that while blood tests that flag Alzheimer’s risk exist, most people don’t know they’re available — and not every insurance plan covers them.
Through the Alzheimer’s Policy Working Group, he is working with roughly 15 major health systems training primary care physicians to spot cognitive decline and order the right tests themselves, rather than routing every patient into an already backlogged neurology system.
Coticelli also believes cognitive screening should be added to Medicare’s annual wellness visit, the same way doctors already check cholesterol or blood pressure.
What Early Alzheimer’s Detection Could Save Patients
Coticelli argues early detection isn’t just a medical win, it’s a financial one.
Florida data suggests the state could save roughly $100,000 per patient per year by keeping people in home- and community-based care instead of nursing homes. He also cites a USC Schaeffer Center analysis estimating that starting Alzheimer’s treatment two years earlier could save around $40,000 per patient over a lifetime.
Multiply either figure across millions of patients, and Coticelli’s case is that brain health belongs in the same category as any other national economic priority.
Watch the full episode to hear Coticelli’s personal story and why he believes staying connected to aging parents matters as much as any blood test.
FAQs About Alzheimer’s Genes, Tests, and Healthcare
What is p-tau217, and how is it used in Alzheimer’s diagnosis?
P-tau217 is a blood-based biomarker test that reflects the likelihood of amyloid buildup in the brain, one of the earliest detectable signs of Alzheimer’s disease. A primary care doctor can order it without a specialist referral, which is part of why advocates like Coticelli want it used more widely.
What does the APOE4 gene reveal about Alzheimer’s risk?
About 25 percent of people carry one copy of the APOE4 gene, and 2 to 3 percent carry two copies, according to the National Institute on Aging. Carrying even one copy raises Alzheimer’s risk, and two copies raise it substantially further. Inheriting APOE4, however, doesn’t guarantee that someone will develop the disease (National Institute on Aging).
What is the Alzheimer’s Policy Working Group?
The Alzheimer’s Policy Working Group is a network of roughly 15 major health systems, made up of neurologists, geriatricians, primary care physicians, and health system leaders, working to diagnose Alzheimer’s earlier and get patients into treatment and care faster. Phil Coticelli serves as its executive director.
Why doesn’t Medicare’s annual wellness visit include cognitive screening?
Medicare’s annual wellness visit currently asks only a general question about memory problems, rather than administering a validated cognitive test. Coticelli argues that should change, especially since about half of eligible seniors use their annual wellness visit each year.
How much could early Alzheimer’s detection save on healthcare costs?
Estimates vary, but Coticelli points to Florida data suggesting roughly $100,000 in savings per patient per year through home-based care, and a USC Schaeffer Center analysis estimating $40,000 in lifetime savings per patient when treatment starts two years earlier (USC Schaeffer Center).