Alzheimer’s disease is often discussed in terms of new drugs, scientific breakthroughs, and high treatment costs.
But for many families, the daily reality of dementia is shaped not only by medication, but by the support they receive while caring for a loved one.
A new study from researchers at the University of California, San Francisco suggests that a Medicare-covered care program that supports caregivers and patients may provide more overall benefit than an expensive Alzheimer’s drug, especially when quality of life and costs are taken into account.
In recent years, drugs such as lecanemab have gained attention because they can slow the progression of Alzheimer’s disease in some patients.
These medications work by targeting amyloid, a protein that builds up in the brains of people with Alzheimer’s.
While this approach is scientifically important, the benefits are modest and the costs are high. Lecanemab is only approved for people in the early stages of the disease, such as mild Alzheimer’s or mild cognitive impairment, and it requires regular visits to specialty clinics.
This makes it difficult for some patients to access, especially those living in rural areas or those with limited financial resources.
At the same time, UCSF researchers have been studying a very different approach to dementia care. UCSF Health helped develop a collaborative care program called the Care Ecosystem. Instead of focusing mainly on medication, this program provides ongoing support to both patients and caregivers.
Trained care navigators work closely with medical teams and help families manage symptoms, plan for the future, and connect with community resources. These navigators also offer guidance and emotional support, which can be crucial for caregivers who often experience stress, exhaustion, and isolation.
To understand how collaborative care compares with drug treatment, the researchers used data from previous studies to create a simulated group of 1,000 patients with dementia. About half of these patients had mild Alzheimer’s disease, while the other half had mild cognitive impairment, which often comes before Alzheimer’s.
The researchers then compared outcomes under different treatment approaches, including usual care, collaborative care, and collaborative care combined with lecanemab.
The results showed that replacing usual care with collaborative care led to meaningful improvements. Patients gained an extra 0.26 quality-adjusted life years, a measure that reflects not just living longer, but living with better health and function.
When lecanemab was added on top of collaborative care, patients gained an additional 0.16 quality-adjusted life years. This suggests that while the drug adds some benefit, the larger improvement comes from the care program itself.
Collaborative care also reduced overall health care costs. While adding lecanemab increased costs by more than $38,000 per patient, collaborative care saved around $48,000 per patient. These savings came in part from fewer hospital visits and better coordination of care.
Patients who received collaborative care also stayed in their homes about four months longer on average before needing to move into a nursing facility. For many families, staying at home longer is a major goal and an important measure of quality of life.
Another key finding is that collaborative care can help a much wider group of people than medication alone. Drugs like lecanemab are limited to early-stage Alzheimer’s and are not approved for other types of dementia.
In contrast, collaborative care programs can support people with more advanced disease and those with other forms of dementia, which make up a large portion of cases. This makes collaborative care more flexible and more inclusive, especially for patients who cannot access or tolerate drug treatment.
The researchers emphasize that this does not mean new Alzheimer’s drugs are unimportant. Instead, the study suggests that focusing only on medication is not enough.
Dementia affects every part of a person’s life, and caregivers play a central role in managing the disease day to day. Supporting caregivers with education, coordination, and emotional help can reduce stress, improve patient outcomes, and lower costs at the same time.
When reviewing these findings, it becomes clear that collaborative care addresses needs that medication alone cannot. While drugs like lecanemab may slow disease progression for some patients, they do not reduce caregiver burden or help families navigate the complex health system.
This study highlights the value of rethinking dementia care as a long-term, team-based effort rather than a single treatment. The results suggest that health systems that combine supportive care programs with new medications may be best prepared to truly improve life for people living with dementia and those who care for them.
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