Dementia research is entering a period of rapid progress, but a shortage of clinical trial participants could slow the development of new treatments and diagnostic tools, Alzheimer’s Disease International (ADI) has warned.
The warning comes as ADI launches its 2026 World Alzheimer Report, A new era in dementia clinical trials, which identifies 158 potential therapies being evaluated across 192 clinical trials worldwide.
The report estimates that about 55,000 participants are needed to sustain currently active trials. However, stringent eligibility and screening requirements mean an estimated 350,000 people may need to volunteer to meet current recruitment needs.
Eight Phase III trials were scheduled to reach their primary completion dates in 2026, highlighting the scale of research activity underway.
“This is a moment of real hope for dementia research.”
ADI acting chief executive Chris Lynch.
“After decades of frustration, clinical trials have shown for the first time that new treatments can slow the progression of Alzheimer’s disease, and a burgeoning pipeline of treatment trials brings real hope,” he added.
However, Mr Lynch warned that barriers to recruitment could slow progress, including low awareness of clinical trials and referral gaps between doctors, specialists and potential participants.
More than 60 million people are living with dementia globally, with that number projected to exceed 139 million by 2050. More than 60% currently live in low- and middle-income countries.
ADI said clinical trial infrastructure is also unevenly distributed, with almost half of the world’s 6,763 active Alzheimer’s drug trial sites located in North America and other high-income countries.
The report identifies several barriers to participation, including delayed diagnosis, limited access to specialist testing, travel costs, language barriers and the need for care partners to attend trials.
People in the early or pre-symptomatic stages of Alzheimer’s disease can also face additional eligibility challenges, including medical and treatment history requirements.
ADI is calling for greater investment in early diagnosis, research infrastructure and public awareness, alongside changes to trial design to improve accessibility and diversity.
Potential measures include remote assessments, local testing, mobile research services and simpler participation requirements.
Australian Bill Yeates, who has young-onset Alzheimer’s disease and serves on the ADI board, said his experience participating in a clinical trial reflected the importance of research participation.
“Taking part was about being part of something much bigger than myself and helping create a future where others living with dementia might have access to better treatment options,” he said.
Professor Craig Ritchie, chief executive of Scottish Brain Sciences, said the growing pipeline of treatments and diagnostic tools represented a pivotal period for brain health research.
“For the first time, there is a growing pipeline of treatments and tests that have the potential to detect and then delay, slow, and perhaps even prevent Alzheimer’s disease,” he added.
ADI said improving access to clinical trials will be critical to ensuring the benefits of emerging dementia research can reach a broader and more diverse population.
