It’s Nearly Impossible to Diagnose Alzheimer’s Disease in Living People. Bill Gates Wants to Change That

Name practically any disease or condition that afflicts the human body and there’s probably a good test for detecting it — preferably early, when there’s a chance that promising treatments can slow it down or even cure it. Cancer, inherited forms of heart disease, diabetes, hypertension, and even certain mental illnesses can be picked up by tracking hormones, genes or other things circulating in the body.

But that hasn’t been the case with Alzheimer’s disease, the neurodegenerative condition that was first described in 1906, and more than a century later, still doesn’t have a blood test or brain scan that can diagnose it conclusively. Doctors rely heavily on other measures, including cognitive tests, to help them assess changes in memory, recall and orientation. And although in recent years, PET brain imaging technologies have been developed that can pick up signs of the disease, including its hallmark protein plaques, an Alzheimer’s diagnosis is still considered a probable diagnosis, after other potential causes of the symptoms have been ruled out. The only way to truly diagnose Alzheimer’s is during autopsy, when doctors can verify the presence of those amyloid plaques and tau tangles.

Now Bill Gates, who decided to invest $100 million in Alzheimer’s disease research in 2017 and revealed earlier this year that his father was affected by the disease, is now directing some of that commitment to developing a diagnostic test. Such a test would help the 14 million people expected to be affected by the brain disorder in the U.S. by 2050 with the chance to come to terms with their condition, and perhaps, if new treatments are developed, even take advantage of these therapies as early as possible.

Gates announced that he is committing more than $30 million to the Diagnostics Accelerator, a project with the Alzheimer’s Drug Discovery Foundation (ADDF), that will focus on creating new strategies for diagnosing the disease. Gates is joined by Leonard Lauder, co-founder of the Alzheimer’s Drug Discover Foundation, the Dolby Family and the Charles and Helen Schwab Foundation among others in the effort.

The goal, Gates says in a Gates Notes blog post, is to push developments of a “real product for real patients ” by the medical community. The project will solicit and then fund the most promising ideas for developing a test for Alzheimer’s, whether that be in the form of a blood test, a retinal eye scan, a urine or saliva test or even some other innovative way of detecting the signs of the disease. “Imagine a world where diagnosing Alzheimer’s disease is as simple as getting your blood tested during your annual physical,” Gates writes, noting that current methods, including the scans and tests of spinal fluid, can be both invasive and expensive (and many are not covered by insurance).

Dr. Howard Fillit, founding executive director and chief scientific officer of ADDF, tells TIME that “we are looking for innovation and new targets — blood tests as well as saliva, urine and retinal based tests. We’re thinking on a very practical level. We want to improve care, and get a blood or other diagnostic test out there so people can be diagnosed early and accurately. “ He points out that having a diagnostic test for Alzheimer’s would not only identify people earlier in the disease process, and make it possible for them to participate in promising clinical trials of treatments, but also help existing studies of encouraging therapies by providing a way for doctors to track the progression of the disease and how effective the experimental treatment might be. “I think that having a diagnostic test for Alzheimer’s is going to have tremendous implications for accelerating the development of new drugs,” says Fillit.

“Research suggests that future isn’t that far off, and the Diagnostics Accelerator moves us one step closer,” Gates wrote in his blog post.