GAO Finds Gaps in Federal Alzheimer’s Coordination Efforts

Why It Matters

One-third of older Americans die with Alzheimer’s disease or a related dementia, and the number of people living with Alzheimer’s disease and related dementias is expected to nearly double by 2050.

A new Government Accountability Office report found that the National Alzheimer’s Project, established in 2011 to coordinate the federal response to the disease, lacks near-term goals, quantitative targets, and project-level timelines. GAO also found that the office responsible for coordinating the initiative operates with two part-time staff members and no dedicated budget.

The report comes as federal spending on Alzheimer’s disease and related dementias continues to grow. Medicare and Medicaid spending for related services and supports reached an estimated $246 billion in 2025, while federal research funding increased from $448 million in 2011 to $3.9 billion in 2024.

The Science is Moving Faster Than the System

Recent advances have expanded treatment options for Alzheimer’s disease. Research has led to blood tests capable of detecting biological markers associated with Alzheimer’s disease with more than 90% accuracy. The first FDA-approved treatment intended to slow disease progression in early-stage Alzheimer’s disease received approval on July 6, 2023, followed by a second treatment on July 2, 2024. As of June 2025, more than 100 potential treatments targeting different aspects of Alzheimer’s disease were being evaluated in clinical trials.

These developments have created new implementation challenges. Patients require access to early detection tools and treatment options, while providers and caregivers need guidance and support resources.

A Coordinating Body Without Coordination

The Advisory Council on Alzheimer’s Research, Care, and Services was created to help federal agencies and outside experts coordinate efforts under the National Alzheimer’s Project. Through 2024, the council issued 285 recommendations to HHS and other entities. GAO found that 25% of those recommendations were fully implemented and 50% were partially implemented.

The advisory council holds quarterly public meetings, while four subcommittees meet monthly on clinical care, long-term services and supports, research, and risk reduction. However, HHS paused the council’s public quarterly meetings in January 2025 until February 2026, and the council did not issue recommendations in 2025.

In August 2025, HHS terminated 11 of the council’s 12 non-federal members without advance notice or explanation. The 2024 reauthorization of the National Alzheimer’s Project Act expanded federal membership and added new non-federal member categories. Eleven new non-federal members were sworn in at the February 2026 quarterly meeting, but GAO noted that the turnover affected continuity within the advisory process.

Where the Council's Priorities Point

The advisory council has consistently urged more aggressive federal action. Of the 285 recommendations, 110 (about 39%) directly recommended increasing federal spending related to the project. Of those spending-increase recommendations, 74 were directed to Congress, 47 to HHS or its component agencies, and 26 to other federal entities such as the Department of Veterans Affairs.

The council also identified gaps in several areas. Forty-five recommendations addressed access to services and supports, 39 addressed research capacity, 21 addressed governance and coordination, 19 addressed workforce development, 15 addressed clinical care, nine addressed prevention and early intervention, and eight addressed public awareness and education.

The council also issued 33 recommendations focused on reducing regulatory barriers. Sixteen addressed drug and treatment development, while 16 addressed provider and caregiving flexibility.

The National Alzheimer's Project's Structural Deficits

HHS has set six long-term goals for the National Alzheimer's Project in the 2025 National Plan to Address Alzheimer's Disease: prevent and effectively treat Alzheimer's disease and related dementias; enhance care quality and efficiency; expand supports for people with Alzheimer's disease and related dementias and their families; enhance public awareness and engagement; improve data to track progress; and accelerate action to promote healthy aging and reduce risk factors for Alzheimer's disease and related dementias.

However, GAO found that HHS has not established near-term goals with performance measures, quantitative targets, and time frames at the project level for any of the six long-term goals. HHS stopped including a targets-and-time-frames appendix in the National Plan starting with the 2020 National Plan. The 2025 National Plan update was released on April 27, and still did not include specific near-term goals with performance measures, quantitative targets, and time frames at the project level.

ASPE, the office within HHS that supports National Alzheimer's Project activities, has only two staff members, neither of whom is assigned full-time to the work. There is no dedicated appropriation for their efforts. The National Alzheimer's Project Act, reauthorized through 2035 in 2024, did not provide dedicated appropriations for the project's coordinating responsibilities.

What the GAO Found and Recommended

The Government Accountability Office published its report on June 29, following an audit conducted from May 2025 through June 2026. The report was requested by Sen. Susan Collins (R-ME), chair of the Senate Appropriations Committee, and Sen. Rand Paul (R-KY), chair of the Senate Homeland Security and Governmental Affairs Committee.

GAO issued four recommendations to the Secretary of Health and Human Services. The recommendations call for providing implementation updates on advisory council recommendations, establishing measurable near-term goals for the National Alzheimer’s Project, collecting performance information to assess progress, and communicating project progress to stakeholders.

All four recommendations remain open. HHS neither agreed nor disagreed with the recommendations.

The Path Forward

The National Alzheimer’s Project faces a gap between advances in research and the federal government’s ability to coordinate implementation. GAO’s recommendations focus on establishing measurable goals, tracking progress, communicating results, and strengthening the advisory process.

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