Alzheimer’s treatments: what works now and what to expect

Alzheimer’s doesn’t have a cure yet, but treatments can slow decline, ease symptoms, and help daily life. If you or a loved one has a diagnosis, the goal is clear: keep thinking skills and independence as long as possible while avoiding side effects and safety problems.

Medications you’re likely to hear about

There are two main drug groups used today. Cholinesterase inhibitors — donepezil, rivastigmine, and galantamine — are often used in mild to moderate Alzheimer’s. They can help memory and daily function for months to years. Common side effects include nausea, diarrhea, sleep changes, and sometimes slow heart rate. Memantine is used for moderate to severe stages and targets a different brain chemical system; it can reduce agitation and improve thinking for some people.

Newer anti-amyloid antibodies (for example, aducanumab and lecanemab) aim to remove amyloid plaques from the brain. They can slow decline in some patients but bring specific risks like ARIA — swelling or small bleeds seen on MRI. These treatments require regular brain scans and careful monitoring. They are not right for everyone and can be costly; check eligibility, local availability, and insurance coverage before starting.

Practical, non-drug strategies that matter

Medications are one part of care. Controlling blood pressure, cholesterol, and diabetes reduces brain injury and helps preserve thinking. Regular physical activity — a simple walking routine most days — improves mood and brain health. Sleep quality matters: treat sleep apnea and aim for consistent sleep hours. Keep the mind active with social time, puzzles, reading, or familiar hobbies. Occupational therapy and home safety changes reduce falls and frustration.

Behavior changes like agitation or wandering often respond better to routines, clear communication, and environment tweaks than to sedating drugs. Ask a therapist or geriatric specialist for simple plans tailored to daily life.

When choosing a treatment, ask your doctor: What is the goal—improve memory, slow decline, ease behavior? What benefits can I expect and when? What side effects should I watch for? Will I need MRIs or blood tests? Who will manage follow-up?

Think about costs and access. Some advanced treatments require clinic infusions, imaging, and specialist visits. Confirm coverage with Medicare or private insurance, and talk to your pharmacist about safe medication sources and possible interactions with current prescriptions.

Finally, plan for support. Caregiver education, local support groups, and legal planning (power of attorney, advance care wishes) make day-to-day life easier and reduce stress. Treatments work best when the whole care team — doctor, pharmacist, therapist, and family — is on the same page.

If you want, I can help list questions for your next doctor visit or summarize the pros and cons of a specific drug you’re considering.