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Alzheimer’s disease is a progressive brain disorder that can affect memory, thinking, language, behavior, and everyday activities. Persistent or concerning changes deserve a medical evaluation, but symptoms alone cannot establish that someone has Alzheimer’s. Clinicians assess thinking and health together, look for other possible causes, and discuss treatment options according to the person’s stage and circumstances.
What Alzheimer’s disease is
The U.S. Food and Drug Administration (FDA) describes Alzheimer’s disease as “a progressive, irreversible brain disorder that affects memory, thinking, and language skills.” It is the most common cause of dementia, but dementia is a broader term for symptoms that interfere with thinking and daily life; not every memory problem is Alzheimer’s.
Alzheimer’s involves biological changes in the brain. Changes may begin before noticeable symptoms, but having biological changes does not mean every person will develop dementia. The disease is commonly described in preclinical, mild, moderate, and severe stages. These descriptions help explain progression; a clinician determines what applies to an individual.
Late-onset Alzheimer’s usually begins in the mid-60s or later. Onset before age 65 is called early-onset and can occur earlier, though it is rare. These are typical age patterns, not diagnostic rules. The FDA reported that approximately 6.9 million people in the United States were living with Alzheimer’s in 2020 and described it as the seventh leading cause of death among U.S. adults. Those are 2020 figures reported in an FDA communication dated August 28, 2025, not estimates for 2026.
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What symptoms can look like
Memory problems are often among the first noticeable signs, especially difficulty remembering recent events or information. Symptoms and the pace of change vary. Other changes may affect a person’s ability to find words, understand visual information or spatial relationships, reason, or make sound judgments.
As Alzheimer’s progresses, confusion and changes in behavior may become more pronounced, and tasks that were once familiar can become difficult. The effects on daily life matter: a clinician will want to understand not only what the person forgets, but also how changes affect activities and independence.
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When to seek an evaluation
If you or someone close to you is having persistent difficulty remembering recent events or thinking clearly, talk with a doctor. One lapse or an occasional moment of forgetfulness does not prove Alzheimer’s. A family member or friend can help describe changes noticed over time.
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There is no single simple test that explains every case. A clinician combines a history of symptoms and health, assessment of thinking, and medical testing as appropriate. The evaluation also considers other causes, some of which may be treatable.
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What the assessment may include
- Health and symptom history: Questions may cover overall health, past medical problems, medicines, diet, daily activities, and changes in behavior or personality. A family member or friend may be asked what they have observed.
- Thinking and function: Assessment may examine memory, attention, language, problem-solving, or counting, along with the effect of changes on everyday activities.
- Physical and medical checks: A physical or neurological examination and routine blood or urine tests may be part of the workup. A clinician may also evaluate depression or other mental-health factors.
- Further tests when indicated: Depending on the person’s situation, clinicians may use cerebrospinal fluid (CSF) tests or brain imaging such as CT, MRI, or PET. These tests can help assess Alzheimer’s-related changes or investigate other explanations.
Possible alternative or contributing causes include stroke, a tumor, Parkinson’s disease, sleep disturbance, medication effects, infection, another dementia, or depression and other mental-health conditions. A clinician may refer someone to a neurologist, geriatrician, geriatric psychiatrist, neuropsychologist, or memory clinic for further assessment.
What blood biomarker tests can and cannot show
Blood tests for beta-amyloid biomarkers are an evolving area, and availability is limited. The U.S. National Institute on Aging (NIA) notes that some doctors may order these tests, subject to state-specific availability and FDA guidance. A blood-test result alone should not be used to diagnose dementia; it must be considered alongside clinical assessment and other tests. A consumer blood test is not a standalone Alzheimer’s diagnosis.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Alzheimer’s treatment options and their aims
There is currently no cure. Treatment may aim to temporarily improve or stabilize some symptoms, address distressing behavioral symptoms, or slow progression in selected people with early symptomatic disease. No available treatment stops or reverses Alzheimer’s for everyone, and medication choices should be made with the treating clinician.
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| Option | Main aim | Who may be considered | Important considerations |
|---|---|---|---|
| Cholinesterase inhibitors: donepezil, galantamine, or rivastigmine | May temporarily help or stabilize some cognitive or behavioral symptoms; they do not stop the underlying disease. | Used principally in mild to moderate disease. | Whether to use one depends on the individual’s clinical situation and treatment plan. |
| Memantine | May temporarily help or stabilize some symptoms; it does not stop the underlying disease. | Used for moderate to severe disease. | A clinician can assess whether it is appropriate for the person and stage. |
| Lecanemab (Leqembi) or donanemab (Kisunla) | Amyloid-targeting, disease-modifying treatment intended to slow progression in selected patients; neither is a cure. | Selected patients with early symptomatic disease. FDA labeling for lecanemab calls for initiation at the mild cognitive impairment or mild dementia stage and confirmation of amyloid pathology before treatment. | Suitability requires individualized assessment. Treatment involves weighing potential benefit against risks and the burden of monitoring, including for amyloid-related imaging abnormalities (ARIA). |
The table describes general treatment aims and stages, not a recommendation for a particular person. Route and administration schedule are not specified here; a treating clinician can explain the current regimen and requirements for a particular medicine.
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ARIA and MRI monitoring with lecanemab
ARIA can involve swelling or fluid accumulation in the brain (ARIA-E) or small bleeds and iron deposits (ARIA-H). Serious and life-threatening events, including seizures and death, have been reported. Monitoring is an important part of treatment, not an optional extra.
In a communication dated August 28, 2025, the FDA recommended an additional MRI before the third lecanemab infusion, in addition to MRI monitoring before the fifth, seventh, and fourteenth infusions under existing label guidance. FDA monitoring recommendations and drug labeling can change, so patients and caregivers should follow the current instructions from their treatment team.
The FDA advises patients and caregivers to contact a health professional promptly for possible ARIA symptoms such as headache, confusion, dizziness, vision changes, nausea, difficulty walking, or seizures.
Support for behavioral and emotional symptoms
Agitation, anxiety, sleep problems, depression, and other behavioral symptoms may need attention alongside memory and thinking changes. The NIA describes both medication and non-drug approaches. A clinician can help identify contributing factors and discuss options; comfort and avoiding stressful situations may also matter to the person’s care.
Quick Recap
How to prepare for a medical appointment
- Write down what has changed, when it began, and how it affects daily activities.
- Bring a current medication list and information about relevant health problems, sleep, mood, or recent illness.
- If the person agrees, ask someone who knows them well to share observations or attend the appointment.
- Ask what other causes are being considered, which tests are appropriate, and what the results can and cannot establish.
- If a treatment is discussed, ask about its intended benefit, eligibility, risks, monitoring, and how it fits the person’s health and goals.
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