In every part of the world, people are living longer than they used to. Thanks to scientific advancements, fewer people die young from heart disease, cancer, and infectious diseases. It’s no longer unusual for a person to live well into their 80s and beyond. My dad will celebrate his 92^nd birthday in a couple weeks, a milestone that was practically unimaginable when he was born.

This fact—that people are living longer than ever before—should always be a wonderful thing. But what happens when it’s not?

The longer you live, the more likely you are to develop a chronic condition. Your risk of getting arthritis, Parkinson’s, or another non-infectious disease that diminishes your quality of life increases with each year. But of all the disorders that plague us late in life, one stands out as a particularly big threat to society: Alzheimer’s disease.

You have a nearly 50 percent chance of developing the disease if you live into your mid-80s. In the United States, it is the only cause of death in the top 10 without any meaningful treatments that becomes more prevalent each year. That trend will likely continue as baby boomers age, which means that more families will watch their loved ones suffer from cognitive decline and slowly disappear. Despite this growing burden, scientists have yet to figure out what exactly causes Alzheimer’s or how to stop the disease from destroying the brain.

I first became interested in Alzheimer’s because of its costs—both emotional and economic—to families and healthcare systems. The financial burden of the disease is much easier to quantify. A person with Alzheimer’s or another form of dementia spends five times more every year out-of-pocket on healthcare than a senior without a neurodegenerative condition. Unlike those with many chronic diseases, people with Alzheimer’s incur long-term care costs as well as direct medical expenses. If you get the disease in your 60s or 70s, you might require expensive care for decades.

These costs represent one of the fastest growing burdens on healthcare systems in developed countries. According to the Alzheimer’s Association, Americans will spend $259 billion caring for those with Alzheimer’s and other dementias in 2017. Absent a major breakthrough, expenditures will continue to squeeze healthcare budgets in the years and decades to come. This is something that governments all over the world need to be thinking about, including in low- and middle-income countries where life expectancies are catching up to the global average and the number of people with dementia is on the rise.

The human cost of Alzheimer’s is much more difficult to put into numbers. It’s a terrible disease that devastates both those who have it and their loved ones. This is something I know a lot about, because men in my family have suffered from Alzheimer’s. I know how awful it is to watch people you love struggle as the disease robs them of their mental capacity, and there is nothing you can do about it. It feels a lot like you’re experiencing a gradual death of the person that you knew.

My family history isn’t the sole reason behind my interest in Alzheimer’s. But my personal experience has exposed me to how hopeless it feels when you or a loved one gets the disease. We’ve seen scientific innovation turn once-guaranteed killers like HIV into chronic illnesses that can be held in check with medication. I believe we can do the same (or better) with Alzheimer’s.

I’ve spent considerable time over the last year learning about the disease and the progress made to date. There’s a lot of amazing work being done in this field to delay Alzheimer’s and reduce its cognitive impact. What I’ve heard from researchers, academics, funders, and industry experts makes me hopeful that we can substantially alter the course of Alzheimer’s if we make progress in five areas:

• We need to better understand how Alzheimer’s unfolds. The brain is a complicated organ. Because it’s so difficult to study while patients are alive, we know very little about how it ages normally and how Alzheimer’s disrupts that process. Our understanding of what happens in the brain is based largely on autopsies, which show only the late stages of the disease and don’t explain many of its lingering mysteries. For example, we don’t fully understand why you are more likely to get Alzheimer’s if you’re African American or Latino than if you’re white. If we’re going to make progress, we need a better grasp on its underlying causes and biology.
• We need to detect and diagnose Alzheimer’s earlier. Since the only way to diagnose Alzheimer’s definitively is through an autopsy after death, it’s difficult to identify the disease definitively early in its progression. Cognitive tests exist but often have a high variance. If you didn’t sleep well the night before, that might skew your results. A more reliable, affordable, and accessible diagnostic—such as a blood test—would make it easier to see how Alzheimer’s progresses and track how effective new drugs are.
• We need more approaches to stopping the disease. There are many ways an Alzheimer’s drug might help prevent or slow down the disease. Most drug trials to date have targeted amyloid and tau, two proteins that cause plaques and tangles in the brain. I hope those approaches succeed, but we need to back scientists with different, less mainstream ideas in case they don’t. A more diverse drug pipeline increases our odds of discovering a breakthrough.
• We need to make it easier to get people enrolled in clinical trials. The pace of innovation is partly determined by how quickly we can do clinical trials. Since we don’t yet have a good understanding of the disease or a reliable diagnostic, it’s difficult to find qualified people early enough in the disease’s progression willing to participate. It can sometimes take years to enroll enough patients. If we could develop a process to pre-qualify participants and create efficient registries, we could start new trials more quickly.
• We need to use data better. Every time a pharmaceutical company or a research lab does a study, they gather lots of information. We should compile this data in a common form, so that we get a better sense of how the disease progresses, how that progression is determined by gender and age, and how genetics determines your likelihood of getting Alzheimer’s. This would make it easier for researchers to look for patterns and identify new pathways for treatment.

By improving in each of these areas, I think we can develop an intervention that drastically reduces the impact of Alzheimer’s. There are plenty of reasons to be optimistic about our chances: our understanding of the brain and the disease is advancing a great deal. We’re already making progress—but we need to do more.

I want to support the brilliant minds doing this work. As a first step, I’ve invested $50 million in the Dementia Discovery Fund—a private fund working to diversify the clinical pipeline and identify new targets for treatment. Most of the major pharmaceutical companies continue to pursue the amyloid and tau pathways. DDF complements their work by supporting startups as they explore less mainstream approaches to treating dementia.

I’m making this investment on my own, not through the foundation. The first Alzheimer’s treatments might not come to fruition for another decade or more, and they will be very expensive at first. Once that day comes, our foundation might look at how we can expand access in poor countries.

But before we can even begin to think about how we do that, we need lots of scientific breakthroughs. With all of the new tools and theories in development, I believe we are at a turning point in Alzheimer’s R&D. Now is the right time to accelerate that progress before the major costs hit countries that can’t afford high priced therapies and where exposure to the kind of budget implications of an Alzheimer’s epidemic could bankrupt health systems.

This is a frontier where we can dramatically improve human life. It’s a miracle that people are living so much longer, but longer life expectancies alone are not enough. People should be able to enjoy their later years—and we need a breakthrough in Alzheimer’s to fulfill that. I’m excited to join the fight and can’t wait to see what happens next.

Can Alzheimer’s disease be funny? I was skeptical, especially given the devastating experience my family had watching my dad suffer from it. So, I asked two experts in using humor to raise awareness—Seth Rogen and Lauren Miller Rogen—to help me see the light. We had a great conversation about their organization Hilarity for Charity, hope for the future of Alzheimer’s research, the importance of a good night’s sleep, and why Seth started a cannabis lifestyle company. 

This month marks one year since we lost my dad. It’s hard to believe that he’s already missed a full cycle of birthdays, holidays, and family get-togethers. My family is slowly learning how to adjust to life without him, although I don’t think things will ever feel normal again. I miss him every day.

My dad died from Alzheimer’s disease, which means that my family’s grief is far from unique. More people die from Alzheimer’s every year than from breast cancer and prostate cancer combined, and millions are suffering from the disease. Today, one out of every nine people aged 65 or older has Alzheimer’s disease. Too many families are being forced to watch their loved ones go downhill and disappear. It’s a brutal way to lose someone, and right now, there’s no way to stop or even slow down the decline.

I’ve written a lot on this blog about why I’m optimistic that new breakthroughs may someday soon let us substantially alter the course of the disease. One of the areas where we’ve seen the most progress over the past couple years is diagnostics.

The current process for diagnosing Alzheimer’s is a huge hurdle standing in the way of a breakthrough. If we’re going to find a game-changing treatment, we will need to test many different hypotheses, which would mean we need to conduct lots of clinical trials. That requires recruiting a lot of participants early enough in their disease that a drug might make a difference. But patients have to show signs of cognitive decline before they know to get tested—which means that their Alzheimer’s is already quite advanced—so many potential volunteers aren’t eligible. We need a cheap, non-invasive way to diagnose patients early before their symptoms get too bad.

The good news is that there are a number of promising new diagnostic tests in the pipeline. I partnered with the Alzheimer’s Drug Discovery Foundation to develop a philanthropic fund called the Diagnostics Accelerator several years ago with the hope that it would kickstart a bunch of new research. We were then joined by Jeff Bezos, MacKenzie Scott, the Dolby family, and several others to expand the effort. The first round of funding is expected to be completed by the end of the year, and many of the award recipients are already making terrific progress.

Some are working on diagnostics that may be available soon, like the simple blood test being developed at the University of Gothenburg in Sweden. Blood tests are the gold standard for diagnosing many diseases for a reason: they’re easy to administer and can be inexpensive to analyze. The test developed at Gothenburg looks for several indicators in the blood, including the presence of a protein called amyloid that can cause plaques in the brain. Samples are run through a common type of diagnostic platform developed by Roche, which means they can be analyzed at most labs.

Having an accessible blood test for Alzheimer’s would be huge. Many of us get our blood drawn once a year during our physical, and it’s easy to imagine a future where your results tell you how your brain is doing, just like how you currently get updates on the state of your heart. I’m hopeful this test will be available within the next year or two.

Other diagnostics in the pipeline use more unexpected methods to detect Alzheimer’s, like an eye test. Cecilia Lee—a researcher at the University of Washington here in Seattle—believes that your retina can provide a window into the brain. In 2018, she published a study showing that having an eye condition like glaucoma or macular degeneration doubles your risk for Alzheimer’s.

Ever since, she’s been looking for ways to use this link to diagnose Alzheimer’s. Cecilia and her colleagues are exploring different ways to scan your eyes for early signs of Alzheimer’s, including by using artificial intelligence to spot tiny irregularities that a human could never find. The UW team isn’t the only group hoping that the eyes are the key to a better diagnostic. Several companies including RetiSpec, Neurovision Imaging, and Optina Diagnostics are using new imaging techniques to look for amyloid plaques. We’re still years away from your annual eye exam including any test for Alzheimer’s, but I’m excited to keep following the research.

All of the tests I’ve mentioned require a trained medical professional and specialized equipment—but what if all you needed to assess your brain health was your smartphone? Several companies are working on highly sophisticated apps that might one day become diagnostics that are accessible to anyone with a phone or tablet. They have tremendous potential, although it’s too soon to tell whether any of them will pan out.

Cogstate is working on a test that looks like a series of mobile games. Each one evaluates a different function of your brain, like your ability to recognize emotions or focus on a task. A different company called Altoida is developing an app for your phone or tablet that uses augmented reality games to assess your cognitive abilities. (If you’ve ever played Pokemon Go, you’ve used AR.) If you score below a certain threshold on either test, your doctor could then order another diagnostic—like a blood test—to confirm whether you have the disease.

Nearly all of the tests I’ve mentioned are being supported by the Diagnostics Accelerator. The fund has invested in 25 candidates to date, and I’m hopeful that we have at least one game changer in the group. The Diagnostics Accelerator is also doing great work to make more samples and data available to researchers, which will hopefully speed up the time it takes to find a breakthrough.

If we want to stop Alzheimer’s, one of the biggest things we need to develop is a reliable, affordable, and accessible diagnostic. I think we’re close to having one, and the developments we’ve seen over the past couple years make me more optimistic than ever that we can one day stop Alzheimer’s. I can’t wait to see what new progress is unlocked thanks to better tests.

My family loves to do jigsaw puzzles. It’s one of our favorite activities to do together, especially when we’re on vacation. There is something so satisfying about everyone working as a team to put down piece after piece until finally the whole thing is done.

In a lot of ways, the fight against Alzheimer’s disease reminds me of doing a puzzle. Your goal is to see the whole picture, so that you can understand the disease well enough to better diagnose and treat it. But in order to see the complete picture, you need to figure out how all of the pieces fit together.

Right now, all over the world, researchers are collecting data about Alzheimer’s disease. Some of these scientists are working on drug trials aimed at finding a way to stop the disease’s progression. Others are studying how our brain works, or how it changes as we age. In each case, they’re learning new things about the disease.

But until recently, Alzheimer’s researchers often had to jump through a lot of hoops to share their data—to see if and how the puzzle pieces fit together. There are a few reasons for this. For one thing, there is a lot of confusion about what information you can and can’t share because of patient privacy. Often there weren’t easily available tools and technologies to facilitate broad data-sharing and access. In addition, pharmaceutical companies invest a lot of money into clinical trials, and often they aren’t eager for their competitors to benefit from that investment, especially when the programs are still ongoing.

Unfortunately, this siloed approach to research data hasn’t yielded great results. We have only made incremental progress in therapeutics since the late 1990s. There’s a lot that we still don’t know about Alzheimer’s, including what part of the brain breaks down first and how or when you should intervene. But I’m hopeful that will change soon thanks in part to the Alzheimer’s Disease Data Initiative, or ADDI.

I worked with a coalition of partners to create ADDI, because we believe that more data sharing will accelerate progress towards an Alzheimer’s breakthrough. To make this happen, ADDI created the Alzheimer’s Disease workbench.

This workbench hosts an open, global, and easy-to-use set of tools and resources. The goal is to simplify how researchers and data scientists around the world work together and share data, code, and knowledge in order to make advances in the field.

Instead of having to navigate dozens of individual databases, scientists will be able to access and upload information to a patient database from around the world. The workbench also facilitates access to datasets from failed drug trials, since many pharmaceutical companies have decided that the benefits of sharing their data outweigh the risks. And all the data is in compliance with privacy laws, so researchers don’t have to worry about compromising anyone’s personal information.

I’m optimistic that this will make a real difference in Alzheimer’s research, because there are many examples where we’ve made progress on diseases after bringing together large amounts of data. One is malnutrition. Several years ago, our foundation launched an initiative to pool information about childhood growth to try to see when exactly a child who ends up stunted starts falling behind.

That information produced some fascinating insights. For example, we learned that, in South Asia, weather cycles play a huge role in whether a child recovers from a period where he or she doesn’t get enough to eat. If you’re born during monsoon season—when food can be harder to come by—you still have a decent shot at getting back on a normal growth curve eventually. But if your mother was in her third trimester during monsoon season, you’re much less likely to get back on track. This insight has implications for how we address malnutrition in that region, and we would have never discovered it without pooling lots of different data sources.

The Alzheimer’s workbench will finally be available to scientists this month after a year and a half in development. (If you work in data science or Alzheimer’s research, or are just a curious researcher, you can explore the AD Workbench here.) But even though the workbench is only now becoming broadly available, we’re already seeing huge benefits from it—just not on the disease we expected.

In the early days of the COVID-19 pandemic, our foundation decided to use the Alzheimer’s workbench framework to create a platform for sharing information on the novel coronavirus. This platform is letting scientists from all around the world collaborate to understand more about the virus and its impacts. Each insight we gain about the virus moves us closer to the end of the pandemic, just as each insight about Alzheimer’s moves us closer to a breakthrough.

I want to be clear: data alone is not going to find the miracle treatment or the diagnostic we need to stop Alzheimer’s (or COVID-19). But what it can do is let us test hypotheses and point us in the right direction.

Nearly forty million people around the world have Alzheimer’s or dementia today. We have no way to stop or even slow the disease at this point. I lost my dad to Alzheimer’s two months ago, and I wouldn’t wish that experience on anyone. My hope is that the data sharing facilitated by ADDI will move us closer to a world where no one has to watch someone they love suffer from this awful disease.

I’ve been learning about (and funding) work on Alzheimer’s Disease for a few years now. In a wrap-up blog post at the end of last year, I wrote about the one area of Alzheimer’s research where I didn’t see a clear path forward: How can we efficiently find enough volunteers for the medical studies that will help us understand the disease better and point toward new ways to diagnose and treat it?

I wish I could tell you that I’ve come across some breakthrough solution for this problem in the past year. I haven’t. But I have learned a lot about why the problem is so hard, where we should look next for possible solutions, and how individuals can help. I thought I’d share what I’ve heard so far.

First, it’s worth recapping why this problem matters. Alzheimer’s is a terrible burden already, and it’s only going to affect more people as the population gets older. Nearly 6 million Americans are living with the disease today, and by mid-century, the number could be as high as 14 million. According to some estimates, caring for people with Alzheimer’s and other types of dementia could cost more than $1 trillion a year by 2050 in the United States alone.

What’s more, we don’t have the scientific tools we need to stop Alzheimer’s. There hasn’t been a new drug for it approved in more than 15 years. That’s in part because it’s so hard to run clinical trials for this disease; the average clinical study for Alzheimer’s takes 4 to 8 years, versus just 1.5 years for a typical study of cardiovascular disease, and is also much more expensive to run.

To understand this problem in more detail, I met with a number of Alzheimer’s experts this year, including researchers supported by the National Institutes of Health. I also asked a group that runs drug studies for pharmaceutical companies to examine the barriers and potential solutions. After talking with dozens of patients, caregivers, doctors, and people who run clinical trials—and surveying many more—we learned about a number of things that make it hard to find volunteers for Alzheimer’s studies.

For one thing, it’s difficult to identify qualified people early enough in the disease’s progression who are willing to participate. People might experience symptoms but not realize they have the disease, and simply not bother to see a doctor. Many doctors have only a limited time with each patient, and they don’t make it a priority to talk about early Alzheimer’s—especially if the person isn’t showing any symptoms.

But suppose the patient makes it to a doctor and the subject of Alzheimer’s does come up. There’s still no cheap, effective way to diagnose the disease. The definitive tests are expensive or invasive—one of them requires a spinal tap, which involves using a needle to puncture your spinal cord—and the doctor may not order them. If she does, her patient might not want to take them. Many people don’t want to find out if they have the disease earlier, because there’s no way to treat it.

Yet even if it turns out to be Alzheimer’s, there are still hurdles to getting into a clinical trial. The doctor might not know about any studies to send her patient to. (The vast majority of people with Alzheimer’s never learn about the chance to take part in a clinical trial.) Or the potential volunteer might shy away from the risks or possible side effects involved in a study of a new drug.

Or she might be put off by a screening process that requires multiple visits to a clinic, invasive procedures, and hours of testing. And even with all those tests, the process isn’t very sensitive; only about 1 out of 10 people screened for certain types of Alzheimer’s trials will actually qualify.

The study itself can be even more burdensome. It can mean traveling great distances—say, if the participant lives in a rural area and the trial is being run at a university-run clinic in town—and reporting once a month for years on end.

As a result, we found that 80 percent of trials don’t meet their recruitment goals on time, which greatly increases the cost of running a trial for pharmaceutical companies. And of all the patients in the healthcare system who could be eligible to participate in a clinical trial on Alzheimer’s, only 1 percent actually do.

The more I learned about all these obstacles, the more I came to admire the volunteers who do participate, and their caregivers too. I was especially moved by James Keach’s 2017 documentary Turning Point: The Quest for a Cure. It’s about the attempt to develop a first-generation drug for Alzheimer’s, and it does a great job of highlighting the challenges and showing how heroic the participants and their caregivers are. (I helped fund a project to show the film to health care professionals and medical students and faculty.)

Here’s a clip from the movie where you meet a couple of patients, their caregivers, and doctors:

The research group I worked with plans to share its findings with the Alzheimer’s community and publish a paper, hopefully next year, that will propose potential solutions. What I can say now is that we see three areas that are worth exploring:

• Increase awareness of Alzheimer’s, so patients start seeking help earlier in the disease’s progression.
• Develop better diagnostics so that doctors can detect the disease sooner and help people enroll in the right clinical trials. (I’m one of a few partners funding work on this through something called the Diagnostics Accelerator.) Researchers are working on various solutions, including simple blood tests and voice analysis performed by a computer.
• Raise awareness of—and openness to—clinical trials among doctors and patients alike.

My hope is that the clinical trial process becomes a lot easier for patients and researchers in the near future. There are a number of people exploring ways to speed up the process. One of them is Dr. Jessica Langbaum, a neuroscientist I met earlier this year, whose lab is developing genetic tests to identify, earlier and more cheaply, people who might qualify for studies on how to prevent Alzheimer’s. Another researcher I’ve met, Dr. Michael Weiner, has created a registry that uses online quizzes to identify potential volunteers.

If you’ve been diagnosed with Alzheimer’s, or if you’re caring for someone who has, I encourage you to consider getting involved in a study. In the United States, the National Institute on Aging has a great online tool that can find one near you; the United Kingdom’s National Health Service has a similar tool. Dr. Langbaum’s Alzheimer’s Prevention Registry and Dr. Weiner’s Brain Health Registry are also great resources.

One of the many awful things about watching someone you love struggle with Alzheimer’s is the feeling of helplessness. You keep thinking, There must be something more I can do. Joining a study won’t make that feeling go away, but by pitching in to fight this disease, you can know that you might help make life a little better for future generations.

How do you stop Alzheimer’s disease without a simple way to diagnose it? It’s a real chicken and egg problem, as I wrote last year on TGN. Discovering a treatment for Alzheimer’s requires lots of clinical trials for new drugs—but it’s difficult to enroll participants without a way to identify people who have the disease early enough for potential treatments to work.

Right now, the best way to diagnose the disease is through a spinal tap or a brain scan. The problem is that the former is invasive and the latter is expensive. Plus, many patients don’t get these tests until they start showing signs of cognitive decline, which means the disease may already be pretty advanced. It’s hard to overstate how important finding a reliable, affordable, and easy-to-use diagnostic is for stopping Alzheimer’s.

The good news is that we’re finally within reach of that goal thanks to significant breakthroughs over the last couple years. Scientists are pushing forward with new diagnostics that range from simple blood tests to voice analysis straight out of a sci-fi novel. We’re close to reaching the point where we can push past the chicken and egg problem.

That’s why I announced last summer that I was investing in a new fund with the Alzheimer’s Drug Discovery Foundation called Diagnostics Accelerator, which aims to accelerate the progress already underway. I am grateful to be joined in this effort by my friends Jeff and MacKenzie Bezos. They have been tremendous partners who are deeply committed to finding an end to this disease. We’ll continue to work together on finding a new way to diagnose Alzheimer’s, as well as on other efforts, over the coming months. In the meantime, the fund is getting ready to announce the first round of awards.

It wasn’t that long ago that we had no way to test for Alzheimer’s beyond cognitive assessments. The first breakthrough came in the late 1990s and early 2000s, when brain imaging (like a PET scan or MRI) allowed us to see biological changes in the brain of someone with the disease.

Then came the spinal tap in 2006. A team of Swedish scientists—Oskar Hansson, Henrik Zetterberg, and Kaj Blennow—demonstrated that you could predict which patients would develop Alzheimer’s disease by looking at cerebrospinal fluid (the fluid found in the brain and spinal cord). Their discovery gave researchers a more accessible tool to make smarter decisions about who should be in a clinical trial. It wasn’t perfect, though—just ask anyone who’s ever had a spinal tap whether they’re eager to undergo the procedure again.

What does the ideal Alzheimer’s diagnostic look like? It needs to be cheap and easy to administer. It should tell us not only whether you have Alzheimer’s, but how far advanced the disease is. (Your cholesterol test doesn’t just tell you that you have cholesterol, after all—it lets you know how much you have and whether it could be a problem.) Above all, it should be as simple and painless as any of the other routine tests you get during your annual physical.

In other words, a blood test would fit the bill.

As recently as two years ago, scientists were skeptical we would ever have a simple blood test for Alzheimer’s. Researchers have been on the hunt for one for a long time, but every time a new lab test showed some promise, the next scientist who tried it couldn’t get the same results.

Enter Randy Bateman, a professor and researcher at Washington University in St. Louis. His team was one of the first to identify changes in the blood of Alzheimer’s patients that remained consistent over many tests. Since he published his research in the summer of 2017, other researchers have released similar findings, and a lot of people are working to perfect the diagnostic (including the Swedish team that discovered the spinal tap test).

There’s a good chance a blood test will start being used to recruit patients into Alzheimer’s drug trials within the next year or two. That’s super exciting, because it means that labs will be able to recruit more patients more quickly, and scientists will be able to figure out whether a drug works in less time. It also means that you’ll one day be able to easily get tested during a routine doctor’s visit.

But what if we could find an even less invasive way to diagnose Alzheimer’s? What if we could use digital technology, not medicine, to identify individuals years before they start to develop mental decline?

I recently met a researcher named Rhoda Au who is working on some seriously cool ways to detect Alzheimer’s. If her research proves successful, we might one day predict whether you will get the disease by simply listening to the sound of your voice or watching how you write with a pen.

Dr. Au is in charge of neuropsychology for the Framingham Heart Study, which has tracked the health of one town’s residents for more than 70 years. Because the study has been going on for so long, some of the participants have developed Alzheimer’s recently—and Dr. Au has access to thousands of audio files of those patients participating in health assessments over the years.

There’s a lot going on when you speak. The whole assembly process of how you string words together and form sentences is complicated. If you could use a computer to analyze how an Alzheimer’s patient speaks over the years, you might be able to pick up on subtle changes—and then look for those same patterns in younger patients who show no other signs of the disease. If you’re able to identify those changes early enough, you might even be able to stop someone from getting Alzheimer’s in the first place (although we’d also need advances in Alzheimer’s prevention to do that).

We don’t know yet if voice analysis will work. It’s still early in the research process, and we don’t even know what changes in speech patterns we’re looking for yet. (Dr. Au is also investigating other digital markers, like whether you could identify changes in writing habits over time using a digital pen.)

But I’m excited about a potential future where identifying your risk of developing Alzheimer’s is as simple as an app on your phone that you can instruct to listen for warning signs in your speech. Starting today, Diagnostics Accelerator is accepting applications for the second round of funding, and they’re specifically looking for ideas that rely on digital tools to detect Alzheimer’s. If you’ve got a great idea, you can apply for funding here.

This is a miraculous age for diagnostics. As technology gets more advanced and more precise, scientists are making amazing progress in how we pinpoint disease. That deeper understanding is already benefitting Alzheimer’s research, and I’m eager to see what other game-changing diagnostics it unlocks in the years to come.

My dad died on Monday of Alzheimer’s disease. He was 94. I have been sharing this obituary, which our family worked on together, with friends and thought I would post it here too. It gives you a sense of the kind of man Dad was and why we all feel so lucky to have had him in our lives. You can also read my own tribute to him here. – Bill Gates

The Gates family mourns the passing of William H. Gates II, known to many as Bill Sr., who died peacefully at his beach home on Hood Canal on September 14, 2020 of Alzheimer’s disease. In his 94 years, Bill created a towering legacy as a lawyer, philanthropist, and activist. To his family, he was a beloved husband, father, and grandfather who was an example of what it means to be a model citizen and a profoundly decent man. To many in the community, he was an inspiring role model, trusted advisor, and loyal friend. His sincerity, humor, approachability, and thoughtfulness won him legions of admirers and made him highly effective in his work and his civic and philanthropic endeavors.

Bill was born on November 30, 1925 and grew up in the Navy town of Bremerton. His father owned a furniture store and neither of his parents went to high school. Bill went to Bremerton High School and was active in Boy Scouts, where his troop spent three summers building a log cabin from the ground up, and he learned his first lesson about the power of people working toward a common goal.

He completed one year at the University of Washington before reporting for duty in the U.S. Army. He completed officer candidate school and was en route to Japan when it surrendered. He spent a year in war-torn Tokyo, which provided him with one of his first opportunities to consider our shared humanity and its ability to unite people regardless of their backgrounds.

Gates returned to the UW to earn an undergraduate degree in 1949 and a law degree the next year. During that time, he gained a lifelong passion for the Husky Nation and met his first wife, Mary Maxwell. Bill and Mary raised two daughters and a son and developed a shared sense of civic duty. Volunteering and philanthropy were nightly topics of conversation around the Gates family dinner table.

Bill and Mary found great joy in nurturing friendships. They were prolific entertainers, and guests could count on meaningful conversation and friendly competition. They and eight other families spent more than 10 summers on Hood Canal at Cheerio resort, where Bill was fondly known as “the mayor.” For several years, they held a holiday skating party where Bill, at 6’7”, could be found wearing a Santa suit on roller skates. Their bridge club met for nearly 60 years.

Bill began his legal career working in private practice and serving part-time as City Attorney for Bremerton. He joined a Seattle law firm, and after 12 years, formed a new firm with two partners. As managing partner, Gates helped grow the firm and today it is known as K&L Gates, one of the world's largest law firms. His firm was involved early in the region’s tech industry, and that involvement expanded over time. Gates retired from the firm, then known as Preston Gates & Ellis, in 1998 after 48 years in practice.

Bill believed in the power of the law to help people and make change for the better. His colleagues admired his integrity, trusted his intelligence, and sought his advice. He engaged in the law’s professional associations, including serving as president of the local and state bar associations, holding leadership positions with the American Bar Association, participating in several court commissions, and other posts. Through these associations, he helped create law school scholarships for people of color and an approach to delivering legal services to the poor.

In addition to being one of Seattle’s most respected lawyers, Bill became one of the city’s most revered civic leaders. He served as an engaged trustee of numerous organizations, including the Greater Seattle Chamber of Commerce, the King County Chamber of Commerce, Planned Parenthood, and United Way of King County. He founded the Technology Alliance and helped boost technology employment in Washington. He chaired the Seattle Public Schools Levy and was a visible advocate for progressive taxation, including initiating a state income tax on the very wealthy, and maintaining an estate tax— reflections of his deep commitment to social and economic equity.

In Showing Up for Life, Bill wrote that “one way to sum up a lifetime quickly is to think of the right words to put on your tombstone.” He thought his should read: “He Married Well.” Despite the intense sorrow of losing Mary to cancer in 1994, he never took for granted how lucky he was to have nearly five decades with her. And then, after Mary passed, he was astonished to find that he could love fully again, when he met and married Mimi Gardner in 1996. Bill and Mimi spent more than 24 years traveling the world, learning, laughing, enjoying life, and simply being together. Mimi and Bill spent his final months at Hood Canal where they could enjoy beautiful views and time outside.

Bill also had a profound impact on the Bill & Melinda Gates Foundation and the people the foundation serves. He, more than anyone else, shaped the values of the foundation. He started the foundation’s work in global health, created the Gates Cambridge Scholars Trust (2000), and guided the foundation’s major investments in human services, education, and culture in the Pacific Northwest. He was quick to tear up when he saw suffering in the world and never let anyone forget the human beings behind the foundation’s strategies. He saw the best in everyone, made everyone feel special, and upheld the foundation motto “All Lives Have Equal Value” in every way possible.

During his lifetime, Bill received innumerable awards including YMCA’s A.K. Guy Award, the Seattle King County REALTORS First Citizen Award, the Distinguished Eagle Scout Award, and the American Bar Association Medal. The University of Washington selected him UW’s Alumnus Summa Laude Dignatus in recognition of his service to and insatiable love for the University. He served as UW Regent for 15 years and directed Campaign UW, which raised $2.7 billion through 293,000 donors. A UW Regent resolution saluted Bill as “patriarch of the first family of the University.” Even in the later stages of Alzheimer’s, Bill could sing the lyrics to “Bow Down to Washington.”

In his characteristically humble way, Bill never saw his actions as anything special—simply the right thing to do—though the community is filled with people and organizations who were changed for the better because of his involvement.

The family would like to thank the tremendously loving and caring people, affectionately named “Team Bill,” who cared for him in the last years of his life. The quality of his life was greatly enhanced by their presence and consistent provision of hot (very hot) coffee, chocolate brownies, and bowl after bowl of chocolate ice cream.

In addition to Mimi, Bill is survived by his children, Kristianne (Kristi) Blake, William (Bill) H. Gates III, and Elizabeth (Libby) MacPhee; their spouses, John Blake, Melinda French Gates, and Nicholas MacPhee; and his grandchildren, Kerry and Sully Blake, Jennifer, Rory and Phoebe Gates, and Emmy, Steve and Mary Armintrout. The family will carry on the traditions that have left a lasting imprint, including matching pajamas at Christmas, time on Hood Canal, and competition and games. His grandchildren will cherish memories of their individual “10-year-old trips” with Poppy and Mimi.

His son, Bill Gates III, once wrote: “The next time someone asks you if you’re the real Bill Gates, tell them you’re all the things the other one strives to be.”

Because of COVID-19 restrictions, the Gates family will hold a memorial service at a later date. To honor Bill’s lifetime of service and generosity, donations may be made to Landesa Rural Development Institute, University of Washington – Achievement Scholars Program & Endowment, the YWCA Seattle-King- Snohomish, or to a charity of your choice.

When I announced that I was investing in Alzheimer’s research for the first time last fall, I thought I knew what to expect. I knew I would get to engage more deeply with the brilliant scientists and advocates working to stop Alzheimer’s—and I haven’t been disappointed. The things I’ve seen over the last seven months make me more hopeful than ever.

What I didn’t see coming was the amazing response I got from the Alzheimer’s community at large. Because my family didn’t talk publicly about my dad’s diagnosis before the announcement, I had yet to experience how remarkable the support community is. So many of you have shared your personal experiences with me, both in person and online (including here on TGN). It helps to hear from others who are going through the same thing.

Alzheimer’s research is a frontier where we can dramatically improve human life—both the lives of people who have the disease and their loved ones. I’m optimistic that we can substantially alter the course of Alzheimer’s if we make progress in several key areas. One of the biggest things we could do right now is develop a reliable, affordable, and accessible diagnostic.

The process of getting diagnosed with Alzheimer’s today is less than ideal. It starts with a cognitive test. If you don’t perform well, your doctor needs to rule out all other possible causes for memory loss, like stroke or a nutritional deficiency. Then your doctor can order a spinal tap or PET scan to confirm you have Alzheimer’s. Although these tests are fairly accurate, the only way to diagnose the disease definitively is through an autopsy after death.

There are two big problems with this process. First, it can be expensive and invasive. Most insurance plans in the United States won’t reimburse tests for Alzheimer’s. Patients often pay thousands of dollars out of their own pockets. Meanwhile, spinal taps can be scary and uncomfortable, and PET scans require the patient to stay perfectly still for up to 40 minutes. That’s difficult for anyone to do—but especially someone with Alzheimer’s.

Second, patients aren’t being tested for the disease until they start showing cognitive decline. The more we understand about Alzheimer’s, the clearer it becomes that the disease begins much earlier than we previously thought. Research suggests Alzheimer’s starts damaging the brain more than a decade before symptoms start showing. That’s probably when we need to start treating people to have the best shot at an effective drug.

This delay is a huge problem in the quest for a scientific breakthrough. It’s currently so difficult to find enough eligible patients for a clinical trial that it can take longer to enroll participants than to conduct the study. We need a better way of diagnosing Alzheimer’s—like a simple blood test or eye exam—before we’re able to slow the progression of the disease.  

It’s a bit of a chicken and egg problem. It’s hard to come up with a game changing new drug without a cheaper and less invasive way to diagnose patients earlier. But most people don’t want to find out if they have the disease earlier when there’s no way to treat it. The commercial market for Alzheimer’s diagnostics simply isn’t there. There’s promising research being done, but very few companies are looking at how to turn that research into a usable product.

That’s why my next investment in Alzheimer’s research is in a new fund called Diagnostics Accelerator. This project of the Alzheimer’s Drug Discovery Foundation (ADDF) aims to accelerate bold new ideas for earlier and better diagnosis of the disease. Today I’m joining Leonard Lauder, ADDF, the Dolby family, the Charles and Helen Schwab Foundation, and other donors in committing more than $30 million to help launch Diagnostics Accelerator.

Diagnostics Accelerator is a venture philanthropy vehicle, which means it’s different from most funds. Investments from governments or charitable organizations are fantastic at generating new ideas and cutting-edge research—but they’re not always great at creating usable products, since no one stands to make a profit at the end of the day. Venture capital, on the other end of the spectrum, is more likely to develop a test that will actually reach patients, but its financial model favors projects that will earn big returns for investors.

Venture philanthropy splits the difference. It incentivizes a bold, risk-taking approach to research with an end goal of a real product for real patients. If any of the projects backed by Diagnostics Accelerator succeed, our share of the financial windfall goes right back into the fund.

My hope is that this investment builds a bridge from academic research to a reliable, affordable, and accessible diagnostic. I expect to see lots of new players come to the table, who have innovative new ideas but might not have previously had the resources to explore them. If you think you’re one of these bold thinkers, we want to hear your great ideas. I encourage you to apply for funding on the new Diagnostics Accelerator website here.

Imagine a world where diagnosing Alzheimer’s disease is as simple as getting your blood tested during your annual physical. Research suggests that future isn’t that far off, and Diagnostics Accelerator moves us one step closer.