Gradient-index Alvarez lenses (GALs), a new, to the best of our knowledge, type of freeform optical component, are surveyed in this work for their unique properties in generating variable optical power. GALs display similar behavior to conventional surface Alvarez lenses (SALs) by means of a freeform refractive index distribution that has only recently been achievable in fabrication. A first-order framework is described for GALs including analytical expressions for their refractive index distribution and power variation. A useful feature of Alvarez lenses for introducing bias power is also detailed and is helpful for both GALs and SALs. The performance of GALs is studied, and the value of three-dimensional higher-order refractive index terms is demonstrated in an optimized design. Last, a fabricated GAL is demonstrated along with power measurements agreeing closely with the developed first-order theory.