Alzheimer’s Disease

What is Alzheimer’s disease?

Alzheimer’s is a brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out simple everyday tasks. In most people, symptoms first appear later in life (National Institute on Aging (opens in a new tab)). It is the most common cause of dementia, accounting for an estimated 60–80% of cases, and it is not a normal part of getting older (Alzheimer’s Association (opens in a new tab)). An estimated 7.4 million Americans aged 65 and older are living with it in 2026 (Alzheimer’s Association, 2026 Facts & Figures (opens in a new tab)).

Abnormal clumps of protein (amyloid plaques) and tangled fibers (tau tangles) build up in the brain, and nerve cells lose their connections and die. These changes may begin a decade or more before symptoms show (NIA (opens in a new tab)).

How it progresses

• Mild: more memory loss, getting lost, trouble handling money, repeating questions and changes in mood or behavior. Many people are diagnosed at this stage.
• Moderate: growing confusion, trouble recognizing family and friends, and difficulty with multistep tasks such as dressing.
• Severe: the person can no longer communicate and depends completely on others for care (NIA (opens in a new tab)).

People typically live about 4 to 8 years after diagnosis, though some live as long as 20 (Alzheimer’s Association (opens in a new tab)).

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Conventional medicine (AMA)

There is no cure for Alzheimer’s yet. Several FDA-approved medicines either ease symptoms or target the disease itself, and most work best in the early or middle stages (National Institute on Aging (opens in a new tab)).

1. Getting a diagnosis

Doctors ask the person and a family member about health, medicines, daily activities and changes in behavior; test memory, attention and language; order blood and urine tests to rule out other causes; check for depression; and may use brain scans (CT, MRI or PET) or spinal fluid tests. A blood test for amyloid is now available in some places, but its result alone should not be used to diagnose dementia. A primary care doctor may refer you to a geriatrician, neurologist, geriatric psychiatrist, neuropsychologist or memory clinic (NIA (opens in a new tab)). An early diagnosis leaves more time to plan and more chances to join clinical trials (NIA (opens in a new tab)).

2. Medicines for symptoms

• Cholinesterase inhibitors — donepezil, galantamine, benzgalantamine and rivastigmine — may help some memory, thinking and behavior symptoms. Over time, as the disease progresses, they lose their effect.
• Memantine, for moderate to severe disease, may help some people keep certain daily abilities a little longer, and can be combined with a cholinesterase inhibitor.
• Common side effects include nausea, vomiting, diarrhea, loss of appetite, headache, dizziness and falls — report anything unusual to the prescriber right away (NIA (opens in a new tab)).

3. Anti-amyloid antibodies for early disease

• Lecanemab (Leqembi) and donanemab (Kisunla) remove amyloid plaques. In studies of people with mild cognitive impairment or mild dementia due to Alzheimer’s, they slowed decline in some participants over 18 months (NIA (opens in a new tab), FDA (opens in a new tab), FDA (opens in a new tab)). In the donanemab trial, decline was about 22% slower than with placebo — roughly seven months’ delay (NPR (opens in a new tab)).
• Who is eligible: only people at the early stage with confirmed amyloid in the brain, shown by a PET scan or spinal fluid test (Alzheimer’s Association (opens in a new tab), NIA (opens in a new tab)).
• Safety (ARIA): both carry the FDA’s strongest (boxed) warning for amyloid-related imaging abnormalities — usually temporary brain swelling, sometimes with small bleeds. Most cases cause no symptoms, but rarely they are serious or life-threatening (FDA (opens in a new tab)). Doctors monitor with MRI scans (NIA (opens in a new tab)). People with two copies of the APOE ε4 gene have a higher risk, so testing for it is advised before starting (FDA (opens in a new tab)).
• How they’re given: donanemab by IV infusion; lecanemab by IV infusion at a hospital or infusion center or as an injection under the skin (Alzheimer’s Association (opens in a new tab)). Donanemab can be stopped once scans show the plaque has cleared (NPR (opens in a new tab)).

4. Behavior, mood and sleep

• Sleeplessness, wandering, agitation, anxiety and depression are common. Experts agree non-drug approaches should be tried first. Antipsychotics carry serious risks, including a higher risk of death in some older people with dementia, and sleep aids can increase confusion and falls. Brexpiprazole is FDA-approved for agitation from Alzheimer’s (NIA (opens in a new tab)).
• For sleep problems and late-day restlessness (“sundowning”), check first for causes such as urinary infections, pain or sleep apnea; keep a steady routine, get daylight, and keep evenings calm and well lit (Alzheimer’s Association (opens in a new tab)).

5. Planning care

Medicare Part B covers a visit to review thinking and memory and build a care plan, including advance care planning and referrals to community resources (Medicare.gov (opens in a new tab)). Some clinicians take part in Medicare’s GUIDE program, which offers care navigators, caregiver training, a 24/7 support line and up to $2,500 a year in respite care for eligible patients (CMS (opens in a new tab)).

What it costs

• Symptom medicines: generic donepezil is inexpensive — a month’s supply is often around $10 with a free discount coupon, depending on pharmacy (GoodRx (opens in a new tab)).
• Anti-amyloid antibodies: Leqembi launched at a list price of about $26,500 a year (BioPharma Dive (opens in a new tab)) and Kisunla at about $32,000 for a year of treatment (NPR (opens in a new tab)). Scans, infusions and MRI monitoring add to the total. Medicare covers these drugs under Part B for eligible people whose doctor takes part in a registry; with Original Medicare you pay 20% coinsurance after the Part B deductible (CMS (opens in a new tab), Alzheimer’s Association (opens in a new tab)).
• Care at home and in facilities (2025 national medians): in-home caregiver about $35 an hour; adult day care about $95 a day; assisted living about $6,200 a month; a semi-private nursing home room about $315 a day, or about $115,000 a year (CareScout Cost of Care Survey (opens in a new tab)). Memory care: cost estimate being researched.
• Who pays: Medicare does not pay for long-term custodial care; Medicaid (if you qualify) and private long-term care insurance may help (Medicare.gov (opens in a new tab)). The lifetime cost of care for someone with dementia is estimated at about $405,000, with roughly 70% carried by families (Alzheimer’s Association (opens in a new tab)).

How well it works — what to expect

Symptom medicines may temporarily improve or steady memory and thinking for some people. The newer antibodies can modestly slow the disease in its early stage but cannot stop or reverse it (NIA (opens in a new tab), NIA (opens in a new tab)). Treating behavior and sleep problems can make the person more comfortable and help caregivers too (NIA (opens in a new tab)).

Find a medical doctor in our directory

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Herbal medicine

Ginkgo

• The large Ginkgo Evaluation of Memory (GEM) trial followed more than 3,000 adults aged 75 and older for a median of about six years. Ginkgo did not lower the rate of dementia or Alzheimer’s, and it didn’t slow progression in people with mild cognitive impairment (JAMA, 2008 (opens in a new tab)).
• Ginkgo extract may have a modest effect on dementia symptoms, but the evidence is inconsistent (NCCIH (opens in a new tab)).
• Safety: ginkgo may increase the risk of bleeding in people taking blood thinners such as warfarin, can interact with other medicines, and raw ginkgo seeds are toxic (NCCIH (opens in a new tab)). Because the anti-amyloid antibodies can also cause small brain bleeds (FDA (opens in a new tab)), anyone on those treatments should tell their care team about every supplement.

Other supplements

• Omega-3s: eating fish is linked with less cognitive decline, but supplements haven’t been shown to help treat Alzheimer’s (NCCIH (opens in a new tab)).
• Vitamin E: most findings are negative; one moderate-quality study suggests it may slow loss of daily function in Alzheimer’s (NCCIH (opens in a new tab)).
• Curcumin (turmeric): human studies are too limited and inconsistent to draw conclusions (NCCIH (opens in a new tab)).
• B vitamins: short-term use hasn’t improved thinking in older adults, and too much vitamin B6 can cause serious side effects (NCCIH (opens in a new tab)).
• Huperzine A showed no more benefit than placebo in a large U.S. trial; coconut oil has never been clinically tested for Alzheimer’s; and coral calcium and phosphatidylserine aren’t recommended (Alzheimer’s Association (opens in a new tab)).

Don’t let a supplement delay a medical evaluation: depression, medicine reactions and thyroid, liver or kidney problems can all cause memory trouble and are treatable (NCCIH (opens in a new tab)). We don’t list doses here — that is a decision for the person’s doctor or pharmacist.

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MBHA Wellness Coach

An MBHA Wellness Coach works alongside the medical team on the everyday habits and plans that support brain health, safety and the whole family.

Heart health is brain health

• Managing blood pressure, diabetes, cholesterol and depression may help protect thinking skills. In the large SPRINT MIND study, people 50 and older who brought their systolic blood pressure below 120 reduced their risk of mild cognitive impairment over five years (NIA (opens in a new tab)).
• Move: federal guidelines recommend at least 150 minutes of physical activity a week; walking is a good start (NIA (opens in a new tab)).
• Eat well: fruits, vegetables, whole grains, fish and less solid fat, sugar and salt. Mediterranean and MIND eating patterns have been linked with lower risk in observational studies, but results aren’t conclusive (NIA (opens in a new tab)): a three-year trial found the MIND diet worked no better for thinking than a control diet with mild calorie cutting (New England Journal of Medicine, 2023 (opens in a new tab)).

Sleep, hearing and staying connected

• Aim for seven to nine hours of sleep; treat hearing or vision loss; limit alcohol and stop smoking (NIA (opens in a new tab)).
• Social activity, volunteering and learning new skills are linked with better thinking in later life (NIA (opens in a new tab)).

Safety at home

• Use appliances with automatic shut-off and stove-knob covers; lock up medicines and use a pill organizer; consider removing firearms or locking them away; keep walkways well lit (Alzheimer’s Association (opens in a new tab)).

Legal and financial planning

While the person can still take part, put in place a durable power of attorney for finances, a health care power of attorney, a living will and a will. Laws vary by state, so an elder law attorney can help (Alzheimer’s Association (opens in a new tab)).

Caring for the caregiver

• Learning about the disease, support groups, good coping skills and respite all help caregivers manage the strain (NIA (opens in a new tab)).
• Respite care — a few hours to several weeks of relief at home, in a facility or at adult day care — can be found through the ARCH National Respite Locator. Most private insurance doesn’t pay for it; Medicaid or long-term care insurance may help, and Medicare covers short respite stays for people in hospice (NIA (opens in a new tab)).
• Your coach can help you reach the Alzheimer’s Association Helpline (800-272-3900), the Eldercare Locator (1-800-677-1116) and Medicare’s GUIDE program (Alzheimer’s Association (opens in a new tab), Eldercare Locator (opens in a new tab), CMS (opens in a new tab)).