Ideagen Radio
Ideagen Radio
2025 Global Leadership Summit: Phyllis Ferrell, David Bates, Christian Howell & Abby Levy — Early Detection, Prevention, and Action in Brain Health
What if brain health were as actionable as heart health—measured early, managed proactively, and supported by tools you can use at home? In this conversation from the Ideagen Global Leadership Summit, we bring together a startup CEO, a medtech innovator, and an age-tech investor to map a path from stigma and late-stage crisis to early detection, prevention, and real treatment options.
The discussion begins by distinguishing Alzheimer’s disease from the broader dementia syndrome, then explores how screening for mild cognitive impairment in primary care could transform lives, finances, and care plans—long before crisis hits.
We unpack the evolving therapy landscape with clarity and realism. Monoclonal antibodies targeting amyloid offer promise but face access and safety challenges. Meanwhile, noninvasive neurostimulation—precisely tuned light and sound to activate neural pathways—is showing potential as a safe, accessible complement to drug-based therapies. Combined with lifestyle interventions like sleep, exercise, and hearing care, the future looks more like coordinated, combination therapy than a single silver bullet.
But breakthroughs need systems that work. The panel gets practical about reimbursement gaps, CMS pathways, and embedding AI-driven cognitive assessments into everyday primary care. Their message to leaders: financial courage, policy alignment, and prevention-first frameworks are essential. Their message to all of us: everyone experiences cognitive change—the choice is whether to prepare.
Get your baseline, talk to your clinician, and share this conversation with someone you love. If this resonates, follow the show, leave a review, and tell us: what’s the next step you’ll take for your brain health?
Okay, ladies and gentlemen, welcome back to the Idea Gen Global Leadership Summit. Excited for the next panel, which is the Brain Health, an aging innovation panel. It's it promises to be inspiring and insightful at minimum. Just gonna tee it up. So with that, my good friend, dear friend, Phyllis Farrell will be the moderator. Welcome, Phyllis.
SPEAKER_03:Thank you, George. We're so pleased to be here. Um I wish you guys could have heard the conversation back stage as we were getting mic'd. That was the fun. Like you should have just, we honestly we should have just been having uh uh sharing a bottle of wine here, and you guys are gonna kind of get to join in in the conversation as we were all um geeked out about what's happening in Alzheimer's disease right now and brain health and longevity. And we're so thankful that Idea Gen has taken this on as one of the world's wicked problems because it is. As we've been more and more successful in communicable and non-communicable disease, um aging is the number one risk factor for Alzheimer's disease and in general and brain health. And it feels really good to be here alongside the United Nations General Assembly 80th meeting because it's only taken us through 2011, but this year Umgum has put dementia on the NCD declaration. So there's just been brain health in every corner here in New York City. So my name is Phyllis Farrell, and I have this wonderful group of colleagues that I work very closely with. Um I'm gonna let them each introduce themselves, and then I'm going to attempt and likely fail to moderate a conversation, but um I'm 100% certain that you're going to have a lot of fun with this one. So, David, will you introduce yourself?
SPEAKER_00:Would you like me to introduce the company?
SPEAKER_03:Why don't you who you are and um why you're here?
SPEAKER_00:Excellent. Well, my name is David Bates. Uh, I'm here because I care about brain health. And uh I work at a company called Linus Health, and we have uh built a platform for brain health enablement and dementia prevention. Uh it's an end-to-end platform for the continuum of care. It leverages artificial intelligence to really help clinicians to care for brain health in their standard workflows and really to take specialist superpowers and transfer them to primary care providers so that a lot of brain health can be addressed right there in primary care. Um great.
SPEAKER_03:We're gonna let you dive in more. So, Christian.
SPEAKER_01:Yeah, hi, it's a pleasure to meet everyone. My name is Christian Howell. I'm the chief executive officer of Cognito Therapeutics. So, Cognito, the question we're trying to answer is what if you could provide a non-invasive neurostimulation to the eight million patients and their families that are suffering with Alzheimer's disease so they could be treated safely, effectively, and cost-effectively in their homes. Um, so we we couldn't be more excited to tell our story.
SPEAKER_02:And Abby. Hi, everybody, I'm Abby Miller-Levy. I'm the managing partner of Primetime Partners. We are a venture fund focused exclusively on the topic of aging and longevity launched in 2020. And personally, I became kind of obsessed with this uh reality that our population for the first time in human history is shifting from a pyramid shape to an upside-down pyramid. And that seismic change in demography is something that, like climate change, we always knew was gonna happen but are unprepared for. And there's no greater area of potential opportunity than brain health to start to make sure we can address um all of the impact of aging by addressing brain health. So really excited for this conversation.
SPEAKER_03:Good. So one of the things that Abby alluded to is uh the shifting demographic. The other thing that's happening, of course, and you guys have already heard about it today, is this amazing opportunity for the impact of technology, artificial intelligence, workflow change. I mean, we just saw about a drone that helped create rain. I mean, just amazing technology and advancement. And the other thing that's happening with this seismic shift is that we don't have enough caregivers as well. So our health systems are overburdened, our caregivers are overburdened, our care staff is overburdened. So wherever we can use technology is going to be important. And then the third major chain that's happened, and I and I know David will talk to this about the importance of early detection, is we now know, thanks to the Lancet Commission, the finger data out of the Karolinska, and the pointer study that was just launched in July by the Alzheimer's Association, we know that over 40% of dementia can be prevented with lifestyle change. So no more do we need to sit around and say, oh, Alzheimer's disease, dementia, this is just normal aging. And if it's coming for me, I can't do anything about it. No, the answer is we can. And so that's what we're gonna talk about a little bit today. Um, the last thing I'll say is I loved that Peter Cunio talked about leadership being courage, because I try to kind of collect people like this. So David nicely said he works for Linus, he's the CEO of Linus Health. You want to talk about courage, you try to be the CEO of a startup company or the founding partner of an age tech fund. This takes courage, it takes tenacity, it takes grit, and it takes an incredible commitment to the patients that we aim to serve. So, David, tell us a little bit about what's happening around Alzheimer's disease and cognitive impairment here in the U.S., we'll start there.
SPEAKER_00:Certainly. So I'd just uh like to start, you know, brain health is incredibly important. It's amazing it's taken so long to recognize that since it's so core to who we are. Um, neurological disorders are the number one disease burden in the world. They affect three and a half billion people. Uh it's a tremendous cost. Um, we talk about leadership, is it seems to be the theme of the day. And you know, how are we caring for our senior population? How much do we value? Do we recognize they are pillars of the community? Um and unfortunately, you know, in the United States, um, up to 15 million people have undiagnosed mild cognitive impairment, the precursor to dementia. And they don't even know it. They're planning a life, a retirement, that they may never realize and they may waste away before then. And it doesn't have to be that way. As Phyllis mentioned, you know, up to 40, I've heard it up to 45% with therapies coming out. Uh that number we fully expect to increase the number of dementias that can be prevented. And much like cancer, it all depends on can you detect it early? Now, Linus Health, we're for lifelong brain health, but we know we need to start with the people at most risk. And so that's why we're heavily focused, our clinically integrated end-to-end platform, on identifying early cognitive impairment and getting those people on a pathway to preserve brain health. Time is brain. They say that in stroke, but it's also very real in cognitive impairment. And the state of play in the Alzheimer's space is is incredible. It is, there's more hope than there's ever been before. I think one important thing I must say is um, you know, stigma is a huge uh prevention, a roadblock to all of brain health. Uh, we heard it earlier today, but I want to say this Alzheimer's disease is not dementia. Too long we've conflated the two. And there may be some fear, there's some stigma. Alzheimer's disease can result in dementia, which is the syndrome, but it doesn't always have to be that way, and it can certainly be slowed down, and that's been shown empirically over time. And again, today is the the the last worst day of the future of Alzheimer's disease and brain health. It is only getting better from here, and so it's important that everyone engages around brain health and they go find out where is my baseline, where am I today, and they educate themselves and we educate providers and drum up that interest, drum up the desire to care for this population, to really promote proactive brain health, early detection, and early intervention to preserve brain health and health span across the lifespan.
SPEAKER_03:I love that you remind everybody that Alzheimer's and dementia are two different things because we do get those very confused. By the way, we're even sloppy in our language in the medical field. Um and we happen to have this mental mindset when someone says Alzheimer's or dementia. We think of the very latest stages of the disease, right? We think of someone who's in that moderate to late stage of dementia, maybe a 90-year-old woman in a wheelchair in the corner. And yet we know now that the plaques, the amyloid plaques, actually build up 10 to 20 years before symptoms. We've been treating this disease in the late stages. Who wants a stage four cancer diagnosis when they could have had it at stage one? So it's it was so fun. Um, David and I actually got to talk to a patient uh yesterday morning. He's here in New York City, and he came to one of our events. His name's Jerry, and Jerry got early detection, he got early diagnosis, he went and got a PET scan, and he was put on one of the new therapies. And Jerry just spent two months in Europe, just got back from fly fishing in Montana. He snowblowers or snowboard snowbirds between New York City and Florida, and was telling us about his stock portfolio. And he's just a mental model of what happens when you catch this disease early. He also told us the plaque is now undetectable in his brain. So it's really incredible what can happen if we change this stigma in the face. So, Christian, I'm gonna come to you because I hinted a little bit at what's going on with therapeutics. You have a unique technology therapeutic and medtech, but why don't you give us a feel of the lay of the land and how you actually think technology can change treatment as well?
SPEAKER_01:Yeah, I mean it's it's amazing what's happening now in the marketplace. And I will say, you know, a credit to Linus, you know, neurologists for years had a phrase which was diagnose and adios, right? Which was this idea that I can diagnose you, but what I I don't have a therapy or treatment for you. And we've seen truly groundbreaking therapies come to market in just the last couple of years, um, focusing on you know with the monoclonal antibodies and and targeting amyloid. But what we've also found is that there's some headwinds to those therapies, that the the brain can be a very challenging organ to treat using chemistry. The blood-brain barrier is quite the fortress to the brain, and um oftentimes the with drug therapy it at times can be indiscriminate. It's looking to remove amyloid, it doesn't know whether the amyloid is on the neuron or in the inner lumen of a vessel. And so what we've learned is that chemistry is bringing real hope, but there's also this idea that physics can bring real hope. And that the central nervous system actually provides this sort of very elegant on-ramp to the brain for us to leverage in order to drive activity and function. And so, you know, what we've learned at Cognito, we get to stand on the shoulders of giants candidly, which is there were two sort of amazing neuroscientists at MIT that learned, you know, an active brain is a healthy brain, and if you can stimulate the brain to a particular activity level, you can drive biology that is unbelievably important to preserving cognition and function and creating a neuroprotective environment. And then they went even further to say, you know, how could we do that in a way that is truly non-invasive? And what they learned was that if you stimulate the optic nerve and you stimulate the auditory nerve using sound and light, that those nerves would actually reciprocate that stimulation and drive activity in the brain, which could then drive biology. So that was the foundation of cognito, but I really do believe cognito is just the first of many that are coming, that are going to find non-invasive, non-chemical ways of driving brain activity to promote biology that'll be very, very important for brain health. And they will be, we will see that this will be in combination. I I'm I I was saying uh backstage, I I I totally I'll kick my coverage with my wife, who's a radiation oncologist. No one would go in for a cancer treatment and say, I'll just take chemotherapy. I'm good, I don't need the radiation. We will address it this way as well, which is we will say, look, I want to find a way to remove the amyloid from my brain, but I also want to find a way to drive brain health and fortify my brain against the progression of the neurodegenerative disease or just the preservation of cognition and function. So it's an incredibly exciting time that I think you're actually the uh crisis is so great that I I am amazed, and Phyllis has really been my steward into this community, how the North Star for everyone is the patient. And the it doesn't matter, we we are all looking for solutions that can impact the patient, and we recognize in combination it's probably the best way to do it, which is an incredibly exciting time.
SPEAKER_03:So I bet you didn't bring one of the Spectrus devices. I did not, sorry, I should have. Can you tell just tell everybody what it looks like?
SPEAKER_01:So it it's um it's quite cool. It looks a little bit like uh an AR-VR headset. Patients wear it an hour a day, every day. There is light that is uh flashed that uh at a particular frequency, which drives uh brain activity, and then there is an audible sound. Um we are, you know, the biggest challenge to our company is it almost seems too simple to be plausible. And so we've really taken that challenge on, and so we have done five human studies. We have just uh enrolled patient 673 in the largest uh pivotal trial that's ever, uh non-drug study that's ever been done in Alzheimer's. And what we're incredibly excited to see is in our previous studies, and in this one, we have a very high adherence rate. So we are north of 85%, meaning patients are using it 50 minutes a day, six days a week, and they tell us that it is uh it is medative, it is comfortable, and they feel empowered to take on um the disease, which is which is an incredible thing to hear.
SPEAKER_03:Well, I would sure rather do that than running for an hour. So I'm I'm good. So, Abby, why the heck would you choose to invest in this space? Uh age tech, I mean, obviously we've got this booming group of of baby boomers, yeah. What what do we have, like 10,000 turning? 12,000 now. 12,000 turning 65 every day. So that sounds like a big market, but it but it's not an easy place to invest. So why do you make this choice and how do you define age tech?
SPEAKER_02:Uh great questions. Um so I I echo the optimism that we're really at this interesting uh time in brain health from a commercial perspective. Uh, because again, as a venture capitalist and and both of your businesses are for-profit, while we're all motivated by the social good of healthcare, we need to figure out how to make it sustainable by making money. And uh I think one of the challenges that the industry has had is that the science wasn't there. Um to have actionable recommendations uh that really could delay, eradicate, improve the experience of having either dementia or Alzheimer's. We are now at the point where we there's plenty of five studies here. I'm sure you've got your own studies, where there are probably 40 different startups, more, 50 different startups, with really great evidence that these solutions work. But what we are missing is the reimbursement models of who pays for it. And that is complicated. And so you ask me why I spend time in this space, I spend time in it because we're actually this great moment in history where we have the science, we have the technology, we have the people, the workforce that wants to spend time. Neurology has become one of the biggest major in undergraduate college institutions. I mean, the fact that my son's high school has a neurology class. When we went to high school, it was chemistry, physics, and biology. Now the fourth science that children are taking is neurology. So we have all of these ingredients, but we don't yet have the policy, and we don't yet have the financial uh risk, financial uh bravery, courage, courage, the financial courage to say I'm willing to spend money today for an outcome 10, 20 years down the road. And so I get excited in my role, which is to say we can make some of those risks as a venture capitalist, to put money behind all of this great momentum that's happening, and then also work with friends, and the Philistine do a lot of work in policy and on things, work with friends to say, okay, we need to do more. So one of the most exciting things that's happened in the field is just in the past two years, the FDA has approved a few drugs, and you can quibble whether, you know, but just in general, that's movement. And a diagnostic. And a diagnostic. And we've got CMS approving the guide model, which is dementia care management. And so we have some, not a ton, but some funding starting to funnel through to payers for taking care of individuals and families addressing this. So the ingredients are there, we're just at the starting point. Like if people do make a lot of analogies between oncology and AD, uh, because it does take 10, 15 years to get the wheel turning and to get that reimbursement and the financial model supporting all the innovation. Um, so you know, that's what gets me excited is that this is a time of we have most of the raw ingredients. Uh, we're missing one important one, but it's it's coming along. Um, I think the other piece that's very interesting is the global community. So I spend a lot of time as an investor in other countries and understanding, and people use Japan all the time, which is, you know, their uh number of people over the age of 65 is closer to 30%. Ours right now is under 20, growing to 25% over the next few years. And so the question is, everyone's like, well, Japanese, you know, what have they figured out? Um and the answer is that they are just in the same place we are with trying to figure out how to fund this. So I think that that's on the one hand discouraging, on the other hand, encouraging of where we can try to work together in the private sector and the public sector and the NGO nonprofit sector. All of those three pieces have to come together to be able to come up with some uh financial courage. Thank you, David, for line editing with me.
SPEAKER_03:We launched um some projects across multiple different countries, high resource countries and low and middle income countries, and it was interesting. One of the leaders of Aga Con University in Africa was explaining some of the problems that they were dealing with. By the way, exact same problems we were in the US. And he his quote, I'll use it again and again. He said, When it comes to Alzheimer's disease, we're all developing nations. And so I think it's really important when we think about the idea gen mission, which is bringing together the public sector and the private sector, the uh philanthropic sector, uh, to really make a difference. So, David, I want to come back to you because um you actually face those headwinds around reimbursement and not even just reimbursement, the the bricks and mortar of workflow. So, for someone that wants to do healthcare system transformation, do you have any advice for them besides hair color and lots of wine?
SPEAKER_00:Yeah, I mean, uh you know, oncology is mentioned, and that was a 50-year journey. We just do not have that kind of time. Uh Alzheimer's uh dementia today, it's uh in the US,$781 billion 2025, 1.5 trillion by 2050. It is unsustainable. And so something has to happen. There's no shortage of medicine and innovation. Cognito is tremendous innovation. Um it is the system, it is the policy, and artificial intelligence is one huge uh aspect that we have to lay hold of in order to get the efficiency and the scale that that's needed to address the problem. But your question is, you know, what about workflows, what about reimbursement? It is not for the faint of the world.
SPEAKER_03:Or does technology help make that tech helps?
SPEAKER_00:Technology helps, uh, but it's human relationships, finding those people that have the courage, that have the grit and the stamina to figure it out and to remember those patients, remember those families, and you you can never lose sight of the reason you're doing it. And then everything else you just figure out. It's an engineering problem. And it actually, the the codes exist, they they certainly can be improved, but you have to design your platform, you have to work with those those uh clinicians, uh, with the administrators, with all the stakeholders of health, especially the parent, I mean the patient and the care partner. Um it's it's huge. But but it is, as I said, I mean, we're we're pushing into the health systems, they're just they're starting to wake up. All the early movers are starting to develop strategies. We're seeing that in the demand, and uh, we're working with these great champions and uh rolling out. So I'm excited about the future, but they're still, especially at the policy level, and just the the strategy, brain health strategy, the commitment and the courage and to boldness that we're gonna do this.
SPEAKER_03:Well, just having this conversation about mild cognitive impairment, I think it's only been two or three years that we actually had a diagnostic code for MCI that we could use, and we still don't have an HCC code for MCI in our U.S. healthcare system. And so when you think about some of those kinds of things, it took us 10 years to get reimbursement for amyloid pet. Uh, we can't wait that long for anything else. So, Christian, you've got a big year uh next year. How are you thinking about introducing technology to the market?
SPEAKER_01:Yeah, it's it's a I'm listening to David and Abby, I mean, I couldn't agree with everyone more, which I mean just to give one to the group of of the young students that were on the stage earlier, one I was incredibly impressed by you guys when you were here. And if I can direct you in one place where we have a leadership gap, is in the healthcare system, right? So that's where we need great minds. We are seeing medicine and technology thrive and healthcare fail. And that's a very important dynamic that we need to change. Uh, it is amazing to me to think that what we are doing is using sound and light to drive activity in the brain in order to express biology that is going to help preserve cognition and function. And the challenges that my company faces are not scientific, they are systemic. And so that is amazing to me to think about, right? That we will, you know, this the our study will read out in uh a year's time. And we are incredibly hopeful that we see a positive readout and we see what we've seen in our previous studies. We are breakthrough with the FDA and we work very closely with them, so then we will take it to the FDA probably at the end of next year, and fingers crossed we will look for what is called a de novo approval, meaning this technology has never been brought forward to the FDA before. But then it becomes murky and cloudy, which is how does CMS pay for it if it it's a medical device, it's not a it's not a uh a drug therapy, we have different models for that. And so I I do think that companies and life science organizations have a responsibility here to make sure that they are bringing robust evidence to change the system. We can't ask uh CMS and payers to just simply change, but not do our part to say, okay, we are going to show that we are validated.
SPEAKER_03:And so you mean Sudoku and crosswords aren't enough?
SPEAKER_01:Yeah, I you know, I know that they're what what's available now, but um I mean Phyllis and I were looking at this matter? Phyllis and I were looking at an article earlier today, and it was it was abstract and it was theoretical, and it was it was hopeful, but the science has to be there. And so, you know, I I am the first to hold uh some of the government organizations accountable and the payers to make sure that they create pathways to get this technology, but we can't shy away from the burden that I think the companies hold, which is to make sure that they are finding partners that will invest that will allow you to explore the clinical validity so you can go to market with real clarity on your impact.
SPEAKER_03:Science matters. I mean, that's one of the reasons why the WHO finally put dementia in with the non-communicable disease, because we actually have data now that shows that you can do something about the disease through lifestyle change. Science matters in making sure that a diagnostic is done well. Nobody wants to be told they have Alzheimer's disease if there is a um non-validated dual giving you that information. It's a hard enough diagnosis.
SPEAKER_02:Well, listen, I know we're at time, but I think one thing that I always love to say is a hundred percent of us, every single person in this room will experience some form of brain health decline. Like as soon as you take it from a them to a me, right, the way the change is gonna happen is because we all demand it to happen. And that's when it becomes a us, not a them. And I think that that is the piece, and I'm not trying to scare you, like, oh, we're all gonna have but we're all gonna have cognitive decline. It's just part of life. And the question is, do we wanna sit and wait for it to happen and say there's nothing we can do? Or has there been such amazing work done to know there's stuff we can do? And I think once you feel that way, that starts when you're age 10. It doesn't start when you're 65. This becomes, just like we talk about heart health, and we've had public service announcements and major campaigns and funding around heart health, we need this for brain health. And so I get really excited when you're in a room of people who are nodding heads as you talk that we are all going to be afflicted, experiencing, challenging some sort of cognitive decline in our lifetime. So why don't we want to take the steps that we need to take to make it to to to re improve that outcome?
SPEAKER_01:Can I add one? I was gonna give you each a closing comment.
SPEAKER_03:But I what did I tell you? There's no chance I was gonna be able to moderate this panel. No. Um well, yeah, go ahead.
SPEAKER_01:Sorry, and this will be my closing comment, which is, and it's completely aligned to what Abby was just saying, which is if we could rewind the clock, we would have thought about the way we adopted streaming and the impact to obesity, or the way that we adopted social media and the impact to depression and isolation. We need to be thinking the same thing about AI. And I this is coming from a guy who runs a company that knows I cannot accomplish what I'm trying to do without AI. But do not kid yourself, AI is not good for brain health. There are studies that are coming out on this. And so we need to be in front of this, saying, without question, AI is gonna have help us solve problems and we know we can't solve the problems, but we also need to be sensitive to the offset to brain health and make sure we put brain health more front and center, because if we don't, it will be a calamity that we are trying to chase rather than being a header.
SPEAKER_03:Absolutely. David, why are you hopeful? What's your closing comment?
SPEAKER_00:My closing comment is to is to echo both of you all. Uh and Abby, your your point on it takes all of us. Um, you know, brain health is so crucial, so core to who we are. And it it's incumbent on us to um to get educated, to know what we can do, to have a lifelong brain health, to take agency over our own brain health, um, and and to to help uh those we care for have um optimal brain health as well. And I do believe today the best thing we can do is is tell one another, uh, especially our parents, people we love, just get tested. Establish a baseline. There are therapies coming. I'm so excited about the the field of play, including cognito. There are things coming, but you won't seek it out if you don't know. And so knowledge is power, brain health is super important. Uh, That's my closing message.
SPEAKER_03:And I just want to thank the Idea Gen group for always making sure that Brain Health is on the agenda. One of the things that's really special about everybody that's in this room and everybody that's watching the live stream is that every single one of you are in a position of influence. I don't know what chair you're in, but you do. You're in a chair that has influence in policy, maybe you have influence in capital, maybe you have influence in getting the word out. You're in a position of influence, and my call to action for all of you is to have the courage to come join us. This needs to be a very large voice that's across multi sectors that's helping us solve this problem. And I'm just so thankful for these guys being up here with us and for all of you being with us today.
SPEAKER_04:Thank you.