Dementia is not a specific disease but is rather a general term for the impaired ability to remember, think, or make decisions that interferes with doing everyday activities. Alzheimer’s disease is the most common type of dementia. Though dementia mostly affects older adults, it is not a part of normal aging.

How common is dementia?

Of those at least 65 years of age, there is an estimated 5.0 million adults with dementia in 2014 and projected to be nearly 14 million by 2060.

Isn’t dementia part of normal aging?

No, many older adults live their entire lives without developing dementia. Normal aging may include weakening muscles and bones, stiffening of arteries and vessels, and some age-related memory changes that may show as:

• Occasionally misplacing car keys
• Struggling to find a word but remembering it later
• Forgetting the name of an acquaintance
• Forgetting the most recent events

Normally, knowledge and experiences built over years, old memories, and language would stay intact.

What are the signs and symptoms of dementia?

Because dementia is a general term, its symptoms can vary widely from person to person. People with dementia have problems with:

• Memory
• Attention
• Communication
• Reasoning, judgment, and problem solving
• Visual perception beyond typical age-related changes in vision

Signs that may point to dementia include:

• Getting lost in a familiar neighborhood
• Using unusual words to refer to familiar objects
• Forgetting the name of a close family member or friend
• Forgetting old memories
• Not being able to complete tasks independently

What increases the risk for dementia?

• Age
  The strongest known risk factor for dementia is increasing age, with most cases affecting those of 65 years and older

• Family history
  Those who have parents or siblings with dementia are more likely to develop dementia themselves.

• Race/ethnicity
  Older African Americans are twice more likely to have dementia than whites. Hispanics 1.5 times more likely to have dementia than whites.

• Poor heart health
  High blood pressure, high cholesterol, and smoking increase the risk of dementia if not treated properly.

• Traumatic brain injury
  Head injuries can increase the risk of dementia, especially if they are severe or occur repeatedly.

How is dementia diagnosed?

A healthcare provider can perform tests on attention, memory, problem solving and other cognitive abilities to see if there is cause for concern. A physical exam, blood tests, and brain scans like a CT or MRI can help determine an underlying cause.

What are the most common types of dementia?

• Alzheimer’s disease. This is the most common cause of dementia, accounting for 60 to 80 percent of cases. It is caused by specific changes in the brain. The trademark symptom is trouble remembering recent events, such as a conversation that occurred minutes or hours ago, while difficulty remembering more distant memories occurs later in the disease. Other concerns like difficulty with walking or talking or personality changes also come later. Family history is the most important risk factor. Having a first-degree relative with Alzheimer’s disease increases the risk of developing it by 10 to 30 percent.

• Vascular dementia. About 10 percent of dementia cases are linked to strokes or other issues with blood flow to the brain. Diabetes, high blood pressure and high cholesterol are also risk factors. Symptoms vary depending on the area and size of the brain impacted. The disease progresses in a step-wise fashion, meaning symptoms will suddenly get worse as the individual gets more strokes or mini-strokes.

• Lewy body dementia. In addition to more typical symptoms like memory loss, people with this form of dementia may have movement or balance problems like stiffness or trembling. Many people also experience changes in alertness including daytime sleepiness, confusion or staring spells. They may also have trouble sleeping at night or may experience visual hallucinations (seeing people, objects or shapes that are not actually there).

• Fronto-temporal dementia. This type of dementia most often leads to changes in personality and behavior because of the part of the brain it affects. People with this condition may embarrass themselves or behave inappropriately. For instance, a previously cautious person may make offensive comments and neglect responsibilities at home or work. There may also be problems with language skills like speaking or understanding.

• Mixed dementia. Sometimes more than one type of dementia is present in the brain at the same time, especially in people aged 80 and older. For example, a person may have Alzheimer’s disease and vascular dementia. It is not always obvious that a person has mixed dementia since the symptoms of one type of dementia may be most prominent or may overlap with symptoms of another type. Disease progression may be faster than with one kind of dementia.

• Reversible causes. People who have dementia may have a reversible underlying cause such as side effect of medication, increased pressure in the brain, vitamin deficiency, and thyroid hormone imbalance. Medical providers should screen for reversible causes in patients who are concerning for dementia.

How is dementia treated?

Treatment of dementia depends on the underlying cause. Neurodegenerative dementias, like Alzheimer’s disease, have no cure, though there are medications that can help protect the brain or manage symptoms such as anxiety or behavior changes. Research to develop more treatment options is ongoing.

Leading a healthy lifestyle, including regular exercise, healthy eating, and maintaining social contacts, decreases chances of developing chronic diseases and may reduce number of people with dementia.

What to do if a loved one is suspicious of having dementia?

• Discuss with loved one. Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
• Medical assessment. Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
• Family Meeting. Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.

Have you been diagnosed with early-stage Alzheimer’s disease, vascular dementia, Lewy body dementia, or a frontotemporal disorder and live alone? Or, do you have mild cognitive impairment (MCI)? If so, these tips are for you.

These tips offer ways to help you cope with changes in memory and thinking, prepare for the future, and stay active.

Make Everyday Tasks Easier

Many people with early-stage dementia continue to manage their everyday activities. But it’s important to look ahead to a time when performing daily tasks will be harder. The sooner you adopt new strategies to help you cope with changes, the more time you will have to adjust to them. Here are some tips:

• Organizing your days. Write down to-do lists, appointments, and events in a notebook or calendar. Some people have an area, such as an entryway table or bench, where they store important items they need each day.


• Paying bills. Setting up automated payments is an easy way to pay your bills correctly and on time without having to write checks. Talk with your utility providers, insurance companies, and mortgage company or leasing office about automatic bill payment. Also consider asking someone you trust to help you pay bills. That person could review your financial statements and ask you about anything unusual.


• Shopping for meals. Many stores offer grocery delivery services. You can also order fresh or frozen meals online or by phone. Meals on Wheels America (1-888-998-6325) can deliver free or low-cost meals to your home, too, and this service sometimes includes a short visit and safety check. Other possible sources of meals include houses of worship and senior centers. If you make your own meals at home, consider easy-to-prepare items, such as foods that you can heat in the microwave.


• Taking medications. Several products can help you manage medications. You can try a weekly pillbox, a pillbox with reminders (like an alarm), or a medication dispenser. You can buy these items at a local drugstore or online. You may need someone to help you set these up. Or try an electronic reminder system, such as an alarm you set on your phone or computer.


• Getting around. If you drive, you may become confused, get lost, or need increasing help with directions. Talk with your doctor about these changes. Take seriously family and friends who express concerns about your driving. Some people decide to give up driving and learn how to use public transportation. For non-drivers, other forms of transportation may be available in your area, or you might want to consider a car or ride-sharing service.

Scan Your Home for Safety

Making minor changes in your home can create a safer environment. For example:

• Get rid of unused items and extra furniture. If there are things you no longer use (such as clothing, appliances, decorations, and furniture) that are filling up your home, now is the time to remove them. Consider donating items in good condition to a charity. Some organizations will pick up from your home.


• Remove throw rugs. Move electrical cords and other things you might trip over. Falls can cause injury and disability and make living alone hard.


• Install an automatic shut-off switch on the stove. If necessary, have your stove disabled. Instead, use a microwave or electric device with an automatic shut-off, such as a slow cooker or rice cooker, to heat up food.


• Set the water heater at 120 °F to avoid scalding tap water. Add nonskid mats to showers and tubs.


• Carry identification. Medical ID bracelets and necklaces are helpful in case you get lost or need help. Consider joining the MedicAlert + Alzheimer’s Association Safe Return program (1-800-432-5378). This is an emergency response system for people with Alzheimer’s disease or a related dementia.


• Consider safety devices. Other safety devices you may want to consider include fall monitors, emergency call buttons, and GPS tracking systems. Ask a relative or friend to help you buy the right device and set it up.


• Make sure smoke and carbon monoxide detectors are installed in or near the kitchen and all bedrooms. Check that the batteries are working. Set reminders to check the batteries every 6 months.

Prepare for the Future

Preparing for the future may be the last thing you want to think about. But it will be easier to think about health and finances now rather than later to make sure you have a say in future decisions.

• Get legal and financial matters in order as soon as possible. Prepare or update your will, living will, healthcare power of attorney, and financial power of attorney. Call your lawyer or contact the National Academy of Elder Law Attorneys (1-703-942-5711) to find an attorney. Be sure to let someone you trust know where your documents are kept or give them a copy. Get more information and advice on legal and financial planning.


• Understand your options for in-home care. Family members and friends can often help with everyday activities. If you will need more help, look into options for a personal care assistant or home health care aide and their costs. For example, Medicaid recipients may qualify for a home health care aide, Medicare covers limited home services for people who cannot leave their homes, and the U.S. Department of Veterans Affairs may provide at-home care for some veterans.


• Plan for what happens when you can no longer live alone. There will come a time when you will need more care and support. Could a family member or caregiver move in with you? Or could you move in with them? Professional home care, assisted living communities, and nursing homes are other options. Learn more about long-term care and how to pay for it.


• If you work, consider your options. You could share your diagnosis with your employer and discuss how to adjust your work. Under the Americans with Disabilities Act, employers with more than 15 employees are required to provide reasonable accommodations for people with disabilities. This might include changing your hours, getting reminders, or splitting up large tasks. If you are no longer able to work because of your condition, you may be eligible for disability income through private disability insurance (if you purchased this previously), Social Security, or veterans’ benefits. A Social Security program called Compassionate Allowances ensures quick review of disability claims for people with conditions including early-onset Alzheimer’s, Lewy body dementia, frontotemporal dementia, and some other types of dementia.

Strengthen Your Support System

Family members, friends, or other caregivers may be able to help in different ways. Here are some suggestions:

• Identify people you trust who can visit you regularly and be an emergency contact. Write down and save their phone numbers and other contact information in an obvious place, such as on your refrigerator door or in your wallet or mobile phone. If you have family members who live at a distance, they can still help. Read Getting Started with Long-Distance Caregiving.


• Visit a doctor or neurologist who can track changes in your memory, thinking, and ability to complete everyday tasks. Ask the doctor to provide a care plan and write down care directions (or have a family member or friend take notes during the visit). If travel is difficult, ask your doctor’s office about home visits or visits by phone or computer. The office also may help you find a home health care aide or geriatric care manager, a person who helps older people find services they need.


• Consider sharing your diagnosis with neighbors you trust. Neighbors are often the first people to notice if someone is wandering and looks lost and may be able to help or get help if needed.


• Learn about home- and community-based support and services. Social service agencies, local nonprofits, and Area Agencies on Aging can provide or refer you to in-home help, transportation, and meals to help you live at home. Call the Eldercare Locator (1-800-677-1116) to learn about services in your area, look on your State government or tribal organization’s website, or reach out to community centers and houses of worship.


• Stay connected with technology. Smartphones, tablets, and smart speakers can help with things like the weather and time and connect you with family and friends through video chats, email, and social media. Some devices can help you find your keys and other important items. You may want to get products that are easy to use, such as a five-button remote control or a telephone with pictures for dialing. Whatever technology you consider, start early so you can learn the system and establish a routine. Are you unfamiliar with technology? Ask your local library or community center about classes.


• Talk with others who share your condition. The Alzheimer’s Association has a 24-hour helpline (1-800-272-3900) and both online and in-person support groups. Other support groups are also available online. Many NIA-supported Alzheimer’s Disease Research Centers offer programs to support and engage people with Alzheimer’s disease or a related dementia. Maybe your community has a memory café—a place to enjoy activities and socialize.


• Get help if you need it. If you feel down and are having suicidal thoughts, call the 988 Suicide & Crisis Lifeline at 988 or 800-273-TALK (800-273-8255).

Keep Your Mind and Body Healthy

Being physically active, eating a healthy diet, getting enough sleep, and spending time with family and friends offer proven benefits. They may also help slow the symptoms of Alzheimer’s disease and related dementias.

• Exercise. You don’t have to join a gym or spend a lot of money. Even light housework, gardening, and walking around the neighborhood can have benefits. Experts recommend both aerobic exercise (such as walking) and strength training (such as lifting weights). Learn more about exercise and physical activity.


• Eat right. A healthy diet is proven to influence heart health, which relates to brain health. Learn more about healthy eating.


• Sleep well. Lack of sleep and poor-quality sleep are linked to memory problems. Try to get 7 to 8 hours per night.


• Be mindful. One way to help manage stress and reduce anxiety and depression is a technique called mindfulness. Mindfulness is being aware of what’s happening in the present, both inside and outside of your body. This web page and handout offer overviews of mindfulness in daily living.


• Stay social. People with dementia who live alone don’t manage daily activities as well when they feel lonely. Join a support group, chat with someone regularly, or volunteer at a local school or community organization. For example, you could read to children at the library.

Alzheimer’s disease and related dementias get worse over time. Even simple everyday activities can become difficult to complete. To help cope with changes in memory and thinking, consider strategies that can make daily tasks easier. Try to adopt them early on so you will have more time to adjust. You can:

• Write down to-do lists, appointments, and events in a notebook or calendar.
• Set up automated bill payments and consider asking someone you trust to help manage your finances.
• Have your groceries delivered.
• Manage your medications with a weekly pillbox, a pillbox with reminders (like an alarm), or a medication dispenser.
• Ask your doctor to provide a care plan and write down care directions (or have a family member or friend take notes during the visit).

Participating in activities you enjoy and getting exercise may help you feel better, stay social, maintain a healthy weight, and have regular sleep habits.

Try these tips for a healthy and active lifestyle:

• Try to be physically active for at least 30 minutes on most or all days of the week. But be realistic about how much activity you can do at one time. Several short “mini-workouts” may be best.
• Aim for a mix of exercise types — endurance, strength, balance, and flexibility. For example, you could do a mix of walking or dancing, lifting weights, standing on one foot, and stretching. Even everyday activities like household chores and gardening help you stay active.
• Your diet may need to change as dementia progresses to maintain a healthy weight. Talk with your doctor about the best diet for you, and choose nutritious foods such as fruits and vegetables, whole grains, and lean sources of protein and dairy products. Avoid added sugars, saturated fats, and sodium.
• Stay social by talking on the phone with family and friends, joining an online support group, or going for a walk in your neighborhood.

Some common problems, like those listed below, can make it harder for older people to follow through on smart food choices. Here are some problem-solving suggestions.

Tired of Cooking or Eating Alone?

Maybe you are tired of planning and cooking dinners every night. Have you considered some potluck meals? If everyone brings one part of the meal, cooking is a lot easier, and there might be leftovers to share. Or try cooking with a friend to make a meal you can enjoy together. Also look into having some meals at a nearby senior center, community center, or religious facility. Not only will you enjoy a free or low-cost meal, but you will have some company while you eat.

Problems Chewing Food?

Do you avoid some foods because they are hard to chew? People who have problems with their teeth or dentures often avoid eating meat, fruits, or vegetables and might miss out on important nutrients. If you are having trouble chewing, see your dentist to check for problems. If you wear dentures, the dentist can check how they fit.

Sometimes Hard to Swallow Your Food?

If food seems to get stuck in your throat, it might be that less saliva in your mouth is making it hard for you to swallow your food. Drinking plenty of liquids with your meal might help. There may be other reasons you are having trouble swallowing your food, including problems with the muscles or nerves in your throat, problems with your esophagus, or gastroesophageal reflux disease (GERD). Talk to your doctor about what might be causing the problem.

Food Tastes Different?

Are foods not as tasty as they used to be? It might not be the cook’s fault! Maybe your sense of taste, smell, or both has changed. Growing older can cause your senses to change, but so can a variety of other things such as dental problems or medication side effects. Taste and smell are important for healthy appetite and eating.

Feeling Sad and Don’t Want to Eat?

Feeling blue now and then is normal, but if you continue to feel sad, ask your doctor for help. Being unhappy can cause a loss of appetite. Help might be available. For example, you might need to talk with someone trained to work with people who are depressed.

Just Not Hungry?

Maybe you are not sad, but just can’t eat very much. Changes to your body as you age can cause some people to feel full sooner than they did when younger. Or lack of appetite might be the side effect of a medicine you are taking—your doctor might be able to suggest a different drug.

Try being more physically active. In addition to all the other benefits of exercise and physical activity, it may make you hungrier.

If you aren’t hungry because food just isn’t appealing, there are ways to make it more interesting. Make sure your foods are seasoned well, but not with extra salt. Try using lemon juice, vinegar, or herbs to boost the flavor of your food.

Vary the shape, color, and texture of foods you eat. When you go shopping, look for a new vegetable, fruit, or seafood you haven’t tried before or one you haven’t eaten in a while. Sometimes grocery stores have recipe cards near items. Or ask the produce staff or meat or seafood department staff for suggestions about preparing the new food. Find recipes online. Type the name of a food and the word “recipes” into a search window to look for ideas.

Foods that are overcooked tend to have less flavor. Try cooking or steaming your vegetables for a shorter time, and see if that gives them a crunch that will help spark your interest. Spices, herbs, and lemon juice add flavor to your food, without adding salt.

Trouble Getting Enough Calories?

If you aren’t eating enough, add snacks throughout the day to help you get more nutrients and calories. Snacks can be healthy—for example, raw vegetables with a low-fat dip or hummus, low-fat cheese and whole-grain crackers, or a piece of fruit. Unsalted nuts or nut butters are nutrient-dense snacks that give you added protein. You could try putting shredded low-fat cheese on your soup or popcorn or sprinkling nuts or wheat germ on yogurt or cereal.

If you are eating so little that you are losing weight but don’t need to, your doctor might suggest protein and energy supplements. Sometimes these supplements help undernourished people gain a little weight. If so, they should be used as snacks between meals or after dinner, not in place of a meal and not right before one. Ask your doctor how to choose a supplement.

Physical Problems Making It Hard to Eat?

Sometimes illnesses like Parkinson’s disease, stroke, or arthritis can make it harder for you to cook or feed yourself. Your doctor might recommend an occupational therapist. He or she might suggest rearranging things in your kitchen, make a custom splint for your hand, or give you special exercises to strengthen your muscles.

Devices like special utensils and plates might make meal time easier or help with food preparation.

Can Foods and Medicines Interact?

Medicines can change how food tastes, make your mouth dry, or take away your appetite. In turn, some foods can change how certain medicines work. You might have heard that grapefruit juice is a common culprit when used with any of several drugs. Chocolate, licorice, and alcohol are some of the others. Whenever your doctor prescribes a new drug for you, be sure to ask about any food/drug interactions.

Lactose Intolerant?

Some older people believe they are lactose intolerant because they have uncomfortable stomach and intestinal symptoms when they have dairy products. Your doctor can do tests to learn whether or not you do indeed need to limit or avoid dairy foods when you eat. If so, talk to your healthcare practitioner about how to meet your calcium and vitamin D needs. Even lactose-intolerant people might be able to have small amounts of milk when taken with food. There are non-dairy food sources of calcium, lactose-free milk and milk products, calcium- and vitamin D-fortified foods, and supplements.

Weight Issues Adding to Frailty?

Older people who don’t get enough of the right nutrients can be too thin or too heavy. Some may be too thin because they don’t get enough food. But others might be overweight partly because they get too much of the wrong types of foods. Keeping track of what you are eating could help you see which foods you should eat less of, more of, or not at all.

Obesity is a growing problem in the United States, and the number of older people who are overweight or obese is also increasing. But frailty is also a problem, and not just in thin people. As you grow older, you can lose muscle strength, but you also get more fat tissue. This can make you frail, and in time, you might have problems getting around and taking care of yourself. Being overweight puts you more at risk for frailty and disability.

But, just losing weight is not necessarily the answer. That’s because sometimes when older people lose weight, they lose even more muscle than they already have lost. That puts them at greater risk for becoming frail and falling. They also might lose bone strength and be at more risk for a broken bone after a fall. Exercise helps you keep muscle and bone. Also, for some people, a few extra pounds late in life can act as a safety net should they get a serious illness that limits how much they can eat for a while.

The Dietary Guidelines encourages people 65 and older who are overweight to try to avoid gaining more weight. But, those who are very overweight (obese) might be helped by intentional weight loss, especially if they are at risk for heart disease, suggest the Guidelines. So, if you think you weigh too much, check with your doctor before starting a diet. He or she can decide whether or not losing a few pounds will be good for you and how you can safely lose weight.

Dementia often changes a person’s sleeping habits. You may sleep a lot, or not enough, and wake up many times during the night. Poor sleep quality can make dementia symptoms worse.

Tips for better and safer sleep:

• Follow a regular schedule by going to sleep and getting up at the same time each day, even on weekends or when traveling.
• Develop a relaxing bedtime routine with lowered lights, cool temperature, and no electronic screens.
• Avoid caffeine and naps late in the day.
• Have a lamp that’s easy to reach and turn on, a nightlight in the hallway or bathroom, and a flashlight nearby.
• Keep a telephone with emergency numbers by your bed.
• Talk to your doctor if you have problems sleeping.

Many people may be able to help in different ways. These people might include family members, friends, professional caregivers, community organizations, and others with dementia. For example, you can:

• Ask friends or family to help with needs like cooking, paying bills, transportation, or shopping.
• If you live alone, find people you trust who can visit often.
• Consider letting trusted neighbors know of your diagnosis so they can help if needed.
• Use social service agencies, local nonprofits, and Area Agencies on Aging to connect with in-home help, transportation, meals, and other services.

Carry identification with you in case you get lost or need help. If you drive, talk with your doctor about changes in your driving and take seriously family and friends who express concerns. Make minor changes in the home to create a safer environment to prevent falls and injuries. Good balance, a habit of standing up slowly, and non-skid shoes can also help prevent falls.

Home-safety tips:

• Simplify the amount and layout of furniture and remove small rugs.
• Have a sturdy handrail on stairways.
• Make sure smoke and carbon monoxide detectors are installed in or near the kitchen and in all bedrooms.
• Install an automatic shut-off switch on the stove and set the water heater temperature limit to 120 F to avoid burns.
• Consider safety devices, like fall monitors and emergency call buttons.

If you or a loved one has been diagnosed with Alzheimer’s disease or a related dementia, it may be difficult to think beyond the day to day. However, taking steps now can help prepare for a smoother tomorrow.

Over time, the symptoms of Alzheimer’s and related dementias will make it difficult to think clearly. Planning as early as possible enables you to make decisions and communicate those decisions to the right people.

Below are important legal documents to consider, and resources and tips that can help with planning ahead for health care, financial, long-term care, and end-of-life decisions.

Health Care Planning

Advance directives are legal documents that outline your preferences and apply only if you are unable to make decisions. For health care planning, they communicate a person’s wishes ahead of time. Doctors and other providers follow these directives for your medical treatment. There are two main documents that are part of an advance directive:

• A living will lets doctors know how you want to be treated if you are dying or permanently unconscious and cannot make your own decisions about emergency treatment.
• A durable power of attorney for health care names someone as a “proxy” to make medical decisions for you when you are not able.

If advance directives are not in place and a patient can no longer speak for him or herself, someone else will need to make medical decisions on their behalf. Talk to your family, friends, and health care providers about what types of care you would want. It can also be helpful to talk with your doctor about common problems associated with your condition.

For example, in the later stages of Alzheimer’s disease, people may have trouble swallowing, which can bring food or liquid into the lungs and cause pneumonia. Doctors may recommend a feeding tube connected from the nose to the stomach for nutrition, a ventilator to help with breathing, and antibiotics to fight the lung infection to help with recovery. However, some people may want to focus on comfort rather than recovery if the illness occurs near the end of life.

Medical decisions to consider when planning ahead include:

• A do not intubate (DNI) order, which lets medical staff in a hospital or nursing facility know that you do not want to be put on a breathing machine.
• A do not resuscitate (DNR) order, which tells health care professionals not to perform CPR (cardiopulmonary resuscitation) or other life-support procedures in case the heart or breathing stops.
• Other types of medical orders, which inform health care professionals about your preferences for life-sustaining and life-supporting treatment measures during a medical emergency. These have various names but are commonly called POLST (Physician Orders for Life-Sustaining Treatment) or MOLST (Medical Orders for Life-Sustaining Treatment) forms.
• Organ and tissue donation, which allows healthy organs or other body parts from a person who has died to be transplanted into people who need them.
• Brain donation for scientific research, which helps researchers better understand how Alzheimer’s and related dementias affect the brain and how they might be better treated and prevented.

Financial Planning

Advance directives for financial planning are documents that communicate the financial wishes of a person. These must be created while the person still has the legal capacity to make decisions. Three common documents are included in a financial directive:

• A will specifies how a person’s estate — property, money, and other financial assets — will be distributed and managed when they die. It may also address care for minors, gifts, and end-of-life arrangements, such as funeral and burial.
• A durable power of attorney for finances names someone who will make financial decisions for you when you are not able.
• A living trust names and instructs someone, called the trustee, to hold and distribute property and funds on your behalf when you are no longer able to manage your affairs.

Lawyers can help prepare these documents with you and your family members. 

Long-Term Care Planning

As symptoms progress, long-term care may be needed. People diagnosed with Alzheimer's or a related dementia and their family members should begin planning for the possibility of long-term care as soon as possible. Geriatric care managers, often nurses or social workers, can work with you to create a long-term care plan.

Long-term care can be provided within the home or at an outside facility. At some point, a person with dementia may require around-the-clock care or exhibit behaviors, such as aggression and wandering, that make it no longer safe to stay at home. People who require help full time can move to an assisted living, nursing home, or residential facility that provides many or all of the long-term care services they need. When planning for long-term care, it may be helpful to think about:

• Where the person will live as they age and how their place of residence can best support their needs and safety
• What services are available in the community and how much they will cost
• How far in advance you need to plan so that the person can make important decisions while they are still capable

End-of-Life Planning

Currently, there is no cure for Alzheimer’s and related dementias. Some treatments may help manage symptoms for a period of time. However, a person’s condition will gradually decline and result in death. That’s why planning and making decisions for your health care early on is important. When planning end-of-life care, quality of life should be considered alongside care that may extend life.

If you did not choose a health care proxy or your advance directives are not clear, someone else may need to make decisions for you at the end of life. These situations can be difficult and emotional. For caregivers in the role of making those decisions, it may be helpful to imagine what the person would want and try to choose accordingly.

Tips for Planning

There are tips and checklists that can help you get started on what to do after an Alzheimer’s or related dementia diagnosis. In preparation for the future, you can:

• Start discussions early with your family members.
• Put important papers in one place and make sure a trusted person knows where.
• Update documents as situations change.
• Make copies of health care directives to be placed in all medical files.
• Give the doctor or lawyer advance permission to talk directly with a caregiver if needed.

Planning now will help you and your loved ones later when symptoms of Alzheimer’s or a related dementia worsen.

As you age, you may have concerns about the increased risk of dementia. You may have questions, too. Are there steps I can take to prevent it? Is there anything I can do to reduce my risk? There are currently no approaches that have been proven to prevent Alzheimer’s disease and related dementias. However, as with many other diseases, there may be steps you can take to help reduce your risk.

What Are Risk Factors?

A risk factor is something that may increase the chance of developing a disease. Some risk factors can be controlled while others cannot. For example, a person is not able to control their age, which is the greatest known risk factor for Alzheimer’s and related dementias. Another uncontrollable risk factor is a person’s genes. Genes are structures in our body’s cells that are passed down from a person’s birth parents. Changes in genes — even small changes — can cause diseases.

Race and gender are also factors that influence risk. Research shows that African Americans, American Indians, and Alaska Natives have the highest rates of dementia, and that risk factors may differ for women and men. Researchers are investigating what’s behind these differences.

However, people do have control over their behavior and lifestyle, which can influence their risk for certain diseases. For example, high blood pressure is a major risk factor for heart disease. Lowering blood pressure with lifestyle changes or medication can help reduce a person’s risk for heart disease and heart attack.

To determine which risk factors may prevent a disease or condition, researchers first conduct observational studies to make associations. They then conduct carefully controlled clinical trials. For example, researchers identified an association between high blood pressure and heart attacks and then completed clinical trials to determine that lowering a person’s blood pressure would indeed lower the likelihood of having a heart attack. This is not to say that people who lower their blood pressure definitely won’t have a heart attack. But it significantly lowers the chances.

For Alzheimer’s and related dementias, no behavior or lifestyle factors have risen to the level of researchers being able to say: This will definitely prevent these diseases. But there are promising avenues.

What Do We Know About Reducing Risk for Dementia?

The number of older Americans is rising, so the number of people with dementia is predicted to increase. However, some studies have shown that incidence rates of dementia — meaning new cases in a population over a certain period of time — have decreased in some locations, including in the United States. Based on observational studies, factors such as healthy lifestyle behaviors and higher levels of education may be contributing to such a decline. But the cause and effect is uncertain, and such factors need to be tested in a clinical trial to prove whether they can prevent dementia.

A review of published research evaluated the evidence from clinical trials on behavior and lifestyle changes to prevent or delay Alzheimer’s or age-related cognitive decline. The review found “encouraging but inconclusive” evidence for three types of behavioral changes (called interventions): physical activity, blood pressure control, and cognitive training. The findings mean that interventions in these areas are promising enough that researchers should keep studying them to learn more. Researchers continue to explore these and other interventions to determine whether — and in what amounts or forms — they might prevent dementia.

What Can You Do?

Although there is no effective treatment or proven prevention for Alzheimer’s and related dementias, in general, leading a healthy lifestyle may help address risk factors that have been associated with these diseases.

• Control high blood pressure. High blood pressure, or hypertension, has harmful effects on the heart, blood vessels, and brain, and increases the risk of stroke and vascular dementia. Treating high blood pressure with medication and healthy lifestyle changes, such as exercising and quitting smoking, may help reduce the risk of dementia.
• Manage blood sugar. Higher than normal levels of blood sugar, or glucose, can lead to diabetes and may increase the risk of heart disease, stroke, cognitive impairment, and dementia. Making healthy food choices, getting regular exercise, stopping smoking, and checking glucose levels can help manage blood sugar.
• Maintain a healthy weight. Being overweight or obese increases the risk for related health problems such as diabetes and heart disease. Being active and choosing healthy foods can help maintain a healthy weight.
• Eat a healthy diet. Aim for a mix of fruits and vegetables, whole grains, lean meats and seafood, unsaturated fats such as olive oil, low-fat or nonfat dairy products, and limit other fats and sugars.
• Keep physically active. Physical activity has many health benefits, such as helping to prevent being overweight and having obesity, heart disease, stroke, and high blood pressure. Aim to get at least 150 minutes of moderate-intensity physical activity each week. 
• Stay mentally active. Lots of activities can help keep your mind active, including reading, playing board games, crafting or taking up a new hobby, learning a new skill, working or volunteering, and socializing.
• Stay connected with family and friends. Connecting with people and engaging in social activities can prevent social isolation and loneliness, which are linked to higher risks for cognitive decline and Alzheimer’s disease.
• Treat hearing problems. Hearing loss may affect cognition and dementia risk in older adults and can make it more difficult to interact with others. Protect your ears from loud sounds to help prevent hearing loss and use hearing aids if needed.
• Take care of your mental and physical health. This includes getting your recommended health screenings, managing chronic health issues such as depression or high cholesterol, and regularly checking in with your health care provider.
• Sleep well. Sleeping well is important for both your mind and body. Try to get seven to eight hours of sleep each night. Talk with your doctor if you are not getting enough sleep, sleeping poorly, or think you may have a sleep disorder.
• Prevent head injury. Take steps to prevent falls and head injury, such as fall-proofing your home and wearing shoes with nonskid soles that fully support your feet. Consider participating in fall prevention programs online or in your area. Also, wear seatbelts and helmets to help protect you from concussions and other brain injuries.
• Drink less alcohol. Drinking too much alcohol can lead to falls and worsen health conditions such as diabetes, high blood pressure, stroke, memory loss, and mood disorders. The National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, recommends that men should not have more than two drinks a day and women only one. Learn more at NIAAA’s Rethinking Drinking website.
• Stop tobacco use. At any age, stopping smoking can improve your health and lower the risk of heart attack, stroke, and lung disease.

Researchers cannot say for certain whether making the above lifestyle changes will protect against dementia, but these changes are good for your health and are all part of making healthy choices as you age.

Watch Out for False Alzheimer’s Cures

Although you might see commercials or online advertisements for products promising to improve brain health and prevent dementia, be cautious about such products. There currently is no product that will effectively prevent or treat Alzheimer’s or related dementias. Check with your doctor before trying any new medication or supplement.

What’s Next With Dementia Prevention Research?

More research is needed to find ways to help prevent Alzheimer’s and related dementias. Future research may determine that specific interventions are needed to prevent or delay the disease in some people, but others may need a combination of treatments based on their individual risk factors. Understanding risk factors and choices you can make now is important for both your present and future health. In addition to this website, consider the resources listed below to learn more.

You can also help researchers learn more about preventing dementia by participating in clinical trials and studies.