Alzheimer’s in Real Life: Sue Peschin on Early Detection, Biomarkers, CED, and the ASAP Act

In Episode 126 Joe speaks with Sue Peschin, President and CEO of the Alliance for Aging Research, about what Alzheimer’s and dementia look like in the real world and how policy determines who gets help and when.  Sue explains the mission and 40–year history of the Alliance for Aging Research and lays out the scope of the Alzheimer’s crisis in plain language: who is affected, how dementia types differ, and why neuropsychiatric symptoms like agitation, psychosis, and depression are so often ignored in policy and practice. They discuss why early detection matters more than ever now that disease-modifying therapies and amyloid inhibitors exist, and why so many cases are still missed in primary care. Sue walks through new blood biomarkers, digital cognitive assessments, and how Medicare coverage, CED restrictions, and the proposed ASAP Act will shape access to testing and treatment. Joe and Sue also dig into Coverage with Evidence Development (CED) in Medicare, whether CMS is overstepping what Congress intended under Section 1801, and how restrictive coverage decisions have limited access to Alzheimer’s drugs to a tiny fraction of eligible patients. Finally, they talk about caregiver burden, stigma around behavioral symptoms, and what families and clinicians can realistically do today. If you care about Alzheimer’s, dementia, early detection, blood biomarkers, Medicare coverage, CED, the ASAP Act, primary care, caregiver burden, vascular dementia, and aging research, this episode connects the science with the politics and the lived experience. In This ConversationJoe and Sue cover: Timestamps (Audio platforms) Key Takeaways About Our GuestSue Peschin is President and CEO of the Alliance for Aging Research, the leading nonprofit focused on advancing science, policy, and education to improve healthy aging and access to care. At the Alliance, Sue has driven national work on Alzheimer’s, dementia, neuropsychiatric symptoms, Medicare policy, CED reform, and aging research, empowering older adults and caregivers to advocate for better care.