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Could Online Clinics Speed Up Dementia Diagnoses?
New virtual brain health providers are using telehealth to shorten long waits for dementia care. But there may be limits to what can be done through a screen
Mojo Wang
Key takeaways
- Long waits to see dementia specialists can delay an Alzheimer’s diagnosis and treatment.
- Some health systems are referring patients to new telehealth providers to expand options for people seeking dementia evaluation and care.
- Experts say virtual visits can improve access, but some parts of dementia assessment may work better in person.
No one welcomes a dementia diagnosis. At the same time, having that diagnosis can set some important wheels in motion to learn about treatment options and plan for care down the line. But it can take several months to more than a year to get an appointment with a dementia specialist, and longer in rural areas.
Catherine Patterson’s mother had begun showing worrying signs of cognitive decline, including a 2022 incident where she forgot to pick up her 4-year-old granddaughter from preschool. In 2023 Patterson, acting COO of the nonprofit UsAgainstAlzheimer’s, began attending her mother’s doctor’s appointments. They received a referral to a memory clinic. But the clinic was so booked up, they had to wait a year to be seen. That appointment finally took place in the fall of 2024.
“If I could have reduced that window and gotten her in to see a neurologist before then, I would have jumped on it,” Patterson says. “Earlier diagnosis means you have more options.”
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Her mother finally received a diagnosis of Alzheimer’s in the summer of 2025 after meeting with a neurologist at the memory clinic, more testing, a visit months later with a neuropsychologist and, finally, a PET scan of the brain to look for signs of amyloid plaques.
In mid-2026, Patterson’s organization began offering the option to search for telehealth providers on its website, MyBrainGuide.org.
Virtual dementia care isn’t new — plenty of health care systems provide some online visits and care for people with dementia. But a few start-ups are using telehealth and AI for everything from cognitive testing to diagnosis, followed by a care plan afterward.
“Virtual dementia care can improve access and convenience, but it works best as part of a flexible care model that includes in-person evaluation and treatment when needed,” says Juan Rodriguez, AARP vice president for policy and brain health.
A need for prompt diagnosis
For Stephen Hightower, 73, a retired geriatrician living in Rio Rancho, New Mexico, the pros included how quickly he could be seen, ease of use of the telehealth system and getting medical advice in the comfort of his own home.
Hightower retired a few months before the pandemic. When COVID-19 hit, his former employer asked him to return to work to help out. He jumped right back in. But he began messing things up on the job. He would forget how to correctly put on his protective gear before seeing patients with COVID, and a long-familiar computer system was now a mystery. “All of a sudden I became aware that I am not remembering things I should know,” he says.
He was worried because Alzheimer’s disease runs in his family. But he didn’t act immediately, and he did not confide in his wife, Terri. Meanwhile Terri had noticed changes in his behavior, but she was feeling overwhelmed after a big move to New Mexico, where she was caring for three of their parents. She didn’t raise the topic either.
When Hightower brought his concerns to his primary care physician, he found the doctor had little experience assessing cognitive decline. His local health care system in Albuquerque had only three neurologists on staff, Hightower says, and none were experts in dementia.
Last year the couple got some hopeful news: Their health care system had partnered with Synapticure, which provides neurological care via telehealth. The company had dementia specialists on tap. It was covered by his Medicare Advantage plan. The Hightowers quickly signed up.
“We were very relieved because we didn't have to wait months to see somebody and then have to be referred to someone else, and on down the line,” Terri Hightower remembers.
Their first online meeting with a Synapticure doctor was in December 2025. It lasted more than two hours. That doctor then ordered blood tests, an MRI, a PET scan, cognitive tests and genetic testing. Those tests took place in February, close to their home. They confirmed that Stephen had mild- to moderate-stage Alzheimer’s disease.
In May, the couple met online with a neurologist, who recommended one of the monoclonal antibody treatments aimed at slowing the progression of the disease. In June, those treatments began with an infusion every two weeks. The time span between Hightower’s first virtual appointment and his first treatment was about six months. This is important because monoclonal antibody treatments are effective only when begun at an earlier stage of the disease.
Like the Hightowers, many patients find Synapticure through referrals from doctors and health care systems, says Dr. Melissa Yu, vice president for clinical operations. But, she says, “you don’t need a referral to come see us.” Someone who is concerned about cognition or memory changes can arrange an intake appointment directly on the company’s website. Synapticure operates in all 50 states and Washington, D.C., and it works with Medicare parts A and B, some Medicare Advantage plans and a small number of private health insurance plans.
“People are getting more and more comfortable with an interaction over the screen,” Yu says, including patients with cognitive loss or other neurological issues. The company’s physicians “are really skilled at using that telehealth interaction” to do almost everything they’d do in a clinical setting, she says.
Hightower says he hasn’t missed anything about being in an actual doctor’s office.
“If I can sit here in this chair and Terri’s here and the pups are next to us in the bed, you just feel more comfortable, even if you get a bad diagnosis,” he says.
The couple also appreciates the ease with which any of their four adult kids can join one of the online appointments. No need to fill them in afterward.
The next best thing
Dr. Glen Finney, director of the memory and cognition program at Geisinger Health in Pennsylvania, says seeing patients via video, in their own home, has advantages for the doctor too. “That gives me a better window into their real-world functioning in life,” he says, since they’re in their natural environment rather than stressed-out in a clinical setting after a long car ride.
Finney, a cognitive behavioral neurologist, says he sees around half of his patients via telehealth at least some of the time and the other half solely in person. (He has also consulted for Synapticure.)
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He says a lot of dementia care can successfully take place online, with one caveat. “What I can’t do [virtually] is a full, comprehensive behavioral neurology examination,” he says. This exam is a key part of the diagnostic process. Finney has another option when his patient lives far from his own office: The patient can go to a local Geisinger clinic, where medical staff are trained to conduct the neurological exam. Finney watches the whole thing live via video.
He says it’s the next best thing to an in-person examination. He points out that some aspects of the exam — such as touching the patient’s face to see if they feel a sensation — don’t work well when the doctor is in one place and the patient and caregiver are in another. “Having family members do that doesn’t quite work out,” he says.
Long wait times are the norm
Dr. S. Ahmad Sajjadi is a professor of neurology at the University of California, Irvine. Like Finney, he is a behavioral neurologist, specializing in neurodegenerative diseases including Alzheimer’s and other forms of dementia. A wait of anything from eight to 12 months to see him or a colleague “is unfortunately the norm for us,” he says.
Sajjadi uses virtual visits for some dementia care, particularly when it’s difficult for the patient to travel. But “we don’t provide it as an exclusive solution or some fast-track way of assessing patients.” He sees virtual care as a second-best option.
“A neurological exam is a complex set of things you need to do,” he says. “We get a wealth of information looking at patients walking in front of us. It’s not always possible to see someone walking over a camera.”
Plus, a lot of his patients have hearing problems, he says, and as a result, virtual visits sometimes end before they’re complete because of communication issues. “Many older people are not technologically savvy,” he adds. “I have a good proportion asking for Zoom, but we end up doing [a call] only because they can’t connect to Zoom.”
Sajjadi comes back to one thing: If there were more neurologists specializing in dementia, delays in diagnosis and care wouldn’t be such a big problem. “Across the U.S., we all are in the same boat — the wait times are similar everywhere. We need a solution in terms of increasing the workforce,” he says.
Help for underserved populations
How, then, do online physicians see patients so quickly? Dr. Joel Salinas, cofounder of a virtual dementia clinic called Isaac Health, knows the shortage of behavioral neurologists all too well: He is one himself. But he says his company cuts wait times significantly because it does not rely on this subset of neurologists to assess and treat patients. “We’re using a combination of other specialists, such as neurology-specialized nurse practitioners,” he says. He adds that the company provides “training, proper guardrails and supervision [for these staff] so that we’re not dependent on the few cognitive behavioral neurologists.
“We’re serving a lot of really underserved communities,” he says, including in rural areas, and Spanish speakers, adding, “For people who have difficulty with the internet or technology, we actually send a home care aid to the home to facilitate the visit for them.”
The company partners with Medicare, some insurance companies and various health care systems to reach patients. The largest of these health care systems is NYU Langone in New York City, which refers patients to Isaac Health. Salinas is a clinical associate professor of neurology at New York University’s Grossman School of Medicine.
“I just heard that we were able to get their average wait time from 250-ish days down to about 50 days,” he says.
Remo Health, another virtual dementia clinic, serves patients in Ohio, Oregon and Washington, with plans to roll out its services in more states. Dr. Kaori Sakurai, a primary care physician and a medical director at Remo Health, says the focus of the company is “wraparound care” for dementia patients and their caregivers.
This is something she felt was sorely lacking in her years as a physician focusing on older adults. She had only 15 to 20 minutes to be with a patient at each appointment. “You want to spend time talking to them about their cognitive issues, but there’s not enough time to do that,” she says, “and that doesn’t even take in the needs of the caregiver.”
Remo Health has a team that includes behavioral neurologists and geriatricians, and while Sakurai says the time to diagnosis is much shorter than it would be in the offline world, the company’s main goal is to provide support for both the patient and the caregiver. They can text or email queries about medication or changes in behavior, or any other question that arises. There is also a 24/7 nurse-staffed phone line, because, says Sakurai, “dementia never sleeps.” Rippl and Neuroglee also offer virtual care for those living with dementia.
As Finney sees it, there is no one-size-fits-all in dementia care. It all comes down to the patient and their care partner. “There are a lot of people that want that in-person touch,” he says. “They don’t want to be on a video, and they don’t want their doctor on video.”
Still, he says, there is such demand for dementia care that as long as the quality of the online care is high, he says, “then that is a reasonable alternative.”
Pros and Cons of Virtual Dementia Care
Pros
- Shorter waits for dementia specialists, evaluation, diagnosis and treatment.
- Better access for people in rural and underserved communities.
- Convenient visits from home, reducing travel and stress.
- Easier participation by caregivers and family members who live elsewhere.
- A home setting can help clinicians observe a patient’s everyday functioning.
Cons
- A complete neurological examination cannot always be performed through video.
- Clinicians may have difficulty assessing walking, sensation and other physical signs remotely.
- Hearing problems, limited technology skills and connection issues can disrupt or prevent visits.
- Testing, scans, infusions and portions of an evaluation may still require local, in-person care.
- Virtual care does not solve the underlying shortage of dementia specialists.
The key takeaways were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.
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