Shared Decision Making

Treatment Options for Alzheimer Dementia

This decision aid is for adults with Alzheimer dementia. It is not for people with other causes of dementia.

About Alzheimer Dementia: It starts slowly and gets worse over time. It makes it hard for people to think, remember, and take care of themselves. Treatment cannot cure Alzheimer dementia, but it may help with symptoms.

Patient Questions

What does the option involve?
Self-Care
You will try the following:
  • A healthy diet
  • Physical exercise
  • Brain exercises
  • Reviewing your medicines with your healthcare professional
  • Treating other conditions that may limit your memory and thinking
Cholinesterase Inhibitors
You will take a pill once or twice daily.
You may use a patch instead of a pill.
Memantine
You will take a pill once or twice daily.
Monoclonal Antibodies
You will get medicine through a vein in your arm once every 2 to 4 weeks. This will take about an hour each time.
You will have blood tests and scans of your brain (MRI).
You may be asked to do a genetic test to check your risk of some side effects.
Self-Care
As soon as you find out you have Alzheimer dementia.
You can try it with other options.
Cholinesterase Inhibitors
Any time after you find out you have Alzheimer dementia.
Memantine
When:
  • You have moderate-to-severe symptoms.
  • Other options did not help.
Monoclonal Antibodies
When you have mild symptoms.
Self-Care
Any benefit will be small.
Cholinesterase Inhibitors
Any benefit will be small.
Memantine
Any benefit will be small.
Monoclonal Antibodies
It is not clear if this option will help. More research is needed.
Self-Care
Exercise may help with your daily activities. There is limited research for other self-care.
Cholinesterase Inhibitors
Any benefit will be small.
Memantine
This medicine may not help with your daily activities.
Monoclonal Antibodies
It is not clear if this option will help. More research is needed.
Self-Care
Does not apply
Cholinesterase Inhibitors
Out of 100 people, about:
  • 4 to 20 (4% to 20%) have an upset stomach.
  • 2 to 12 (2% to 12%) have vomiting.
  • 4 (4%) get diarrhea.
  • 3 (3%) have weight loss.
Memantine
Out of 100 people, about:
  • 4 (4%) feel confused.
  • 4 (4%) feel sleepy.
  • 4 (4%) have diarrhea.
Monoclonal Antibodies
There is limited research. Out of 100 people, about:
  • 6 (6%) stop due to side effects.
  • 4 (4%) get a headache.
Out of 100 people, a brain MRI may find:
  • Swelling in 11 to 22 (11% to 22%)
  • Small bleeds in about 10 (10%)
These things may not cause symptoms but should be watched closely.
Self-Care
Research shows dietary supplements are not likely to help. These include:
  • Ginkgo biloba
  • Vitamin B12
  • Folic acid
  • Prevagen
  • Vitamin E
Cholinesterase Inhibitors
You may also take this medicine with memantine.

The cost for the patch is high and may not be covered by insurance.
Memantine
You should not take this medicine if you have severe liver disease.

You may also take this medicine with cholinesterase inhibitors.
Monoclonal Antibodies
Costs are high and may not be covered by insurance.
Self-Care
Does not apply
Cholinesterase Inhibitors
Aricept, Exelon, and Razadyne ER
Memantine
Namenda
Monoclonal Antibodies
Leqembi and Kisunla
Definitions
Magnetic Resonance Imaging (MRI): Magnets and computers will take pictures inside the body. This is done to find a problem (diagnosis) or to see if a treatment is working.
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FAIR Health
The EBSCO Health Option Grid ™ decision aids are not intended to be medical advice, diagnosis or treatment and are intended to provide information to help people engage in shared decision making with health professionals.
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