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Alzheimer's disease
How is Alzheimer's disease diagnosed?
Diagnosis involves a comprehensive assessment:
- Medical history and symptom review
- Cognitive tests, such as memory and thinking assessments (e.g. MMSE, MoCA)
- Blood tests to rule out other causes and consideration of blood-based biomarkers for Alzheimer's disease (e.g. vitamin deficiencies, thyroid disorders)
- Brain imaging, such as CT or MRI scans
- Specialised tests, such as PET scans or cerebrospinal fluid analysis (in selected cases)
- Genetic testing may be required for new treatments
There is no single test; diagnosis is based on a combination of findings.
How is Alzheimer's disease treated?
There is currently no cure for Alzheimer's disease. Treatment focuses on slowing disease progression, managing symptoms, and maintaining quality of life.
Medications
Oral medications
- Cholinesterase inhibitors to support memory and thinking
- Other medications to help regulate brain signalling
- Medications to manage behavioural symptoms such as anxiety, depression, or agitation
Intravenous (IV) infusion therapies
Newer treatments known as monoclonal antibodies are disease modifying, and are administered via IV infusion in specialist centres.
Examples include:
- Lecanemab (approved by HSA May 2025)
- Donanemab (approved by HSA Mar 2025)
These treatments target amyloid plaques in the brain, a key feature of Alzheimer's disease. By reducing amyloid levels, they may help slow the progression of cognitive decline in selected patients.
Key considerations:
- Typically used in early-stage Alzheimer's disease
- Not suitable for all patients (especially moderate to late stages)
- Requires confirmation of amyloid pathology before treatment
- Given regularly via IV infusion (e.g. every two to four weeks)
- Require close monitoring, including periodic MRI brain scans
Risks:
- Potential side effects include brain swelling or small bleeds (known as amyloid-related imaging abnormalities (ARIA))
- Careful specialist supervision is required
These therapies do not cure Alzheimer's disease but represent an important advancement in disease-modifying treatment.
Non-drug approaches
- Cognitive stimulation and memory training
- Structured routines to reduce confusion
- Occupational therapy to support daily functioning
- Regular physical activity to support overall brain health
Supportive and long-term care
- Caregiver education and support
- Home safety modifications
- Nutritional support
- Advance care planning for future healthcare decisions
Frequently asked questions
Can Alzheimer's disease be cured or reversed?
There is currently no cure. Treatment focuses on slowing disease progression and managing symptoms.
What is the life expectancy after diagnosis?
Life expectancy varies but is often between 5 to 20 years after diagnosis, depending on age and overall health.
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