Nearly 18-Week Wait for First Cognitive Care Visits at US Neurology Clinics

People seeking a first cognitive care appointment at US neurology clinics were quoted a mean wait of 17.9 weeks, with longer waits at specialized centers than at community neurology practices, according to a cross-sectional study published in JAMA Network Open.

Investigators from Banner Alzheimer's Institute in Phoenix, Arizona, noted that treatments for Alzheimer's disease and related dementias (ADRD) are most effective when started early, yet the mean interval from symptom onset to diagnosis is 3.5 years. They set out to describe quoted wait times for an initial cognitive care appointment across the US.

Using a standardized script, researchers telephoned neurology clinics and requested an initial appointment for someone concerned about memory, collecting data from June to October 2025 and June to July 2026. The final sample included 150 clinics in all 50 states and the District of Columbia: 64 specialized centers, defined as those affiliated with a university or academic center, a trial consortium, or an Alzheimer's Disease Research Center, and 86 community clinics without academic or research affiliations. Mean wait times were 21.1 weeks at specialized centers and 15.6 weeks at community clinics. Waits were significantly longer at specialized centers (median difference, 7 weeks; 95% CI, 3-11.5 weeks).

Overall, 27.3% of clinics quoted waits of 6 months or longer, including 37.5% of specialized centers and 19.8% of community clinics. Waits were numerically longer in the most populous locations than in the least populous (mean, 20.9 vs 14.7 weeks), but the difference was not statistically significant. The authors said the quoted waits substantially exceeded a previously reported median 34-day referral-to-visit wait among Medicare beneficiaries seeing a neurologist for any indication, although their estimates reflected first-available access without an active referral.

The sample was purposive, so the estimates describe the clinics reached rather than all US practices, the investigators noted. Wait times were staff-reported and were not conditioned on age, insurance, or referral status, and 18 clinics that required patient-specific information before quoting a wait were excluded. The authors suggested that extending specialists' reach through primary care partnerships, advanced practice providers, and technology may help improve timely access.

Source: Knox JC, Chen Y, Pruzin JJ. Wait times for initial cognitive care appointments. JAMA Netw Open. 2026;9(10):e2639836. doi:10.1001/jamanetworkopen.2026.39836