Alzheimer’s disease: a plain-language guide

Brain and nerves, Medical Conditions
18m read

Alzheimer’s disease is a physical illness that slowly damages the brain, starting years before anyone notices symptoms, and it is the most common reason people develop dementia, which is the loss of memory and thinking ability to the point where daily life becomes difficult [1,2,6].

This page provides general information. It does not replace advice from a doctor or another qualified healthcare professional.

Key facts

  • Dementia is the set of symptoms. Alzheimer’s disease is the illness in the brain that most often causes them, contributing to 60 to 70 in every 100 cases [1,6].
  • In 2021, 57 million people worldwide were living with dementia, and more than 60 in every 100 of them live in low-income and middle-income countries [1].
  • Age is the strongest risk factor, and above 65 the risk of Alzheimer’s roughly doubles every five years, yet Alzheimer’s is not a normal part of getting older [1,6,8].
  • Damage in the brain can begin a decade or more before the first symptoms, which is why a diagnosis often comes years after the illness started [2].
  • Blood tests for Alzheimer’s have advanced quickly, and the first one was cleared for use in the United States in May 2025 [27].
  • A sudden change over a day or two is usually delirium caused by something treatable, often an infection, rather than Alzheimer’s suddenly worsening. It needs urgent medical attention [9].

On this page

What is Alzheimer’s disease?

Two words get mixed up constantly. Dementia is the name for a group of symptoms, not one illness: memory loss, muddled thinking, trouble finding words, and needing help with daily life [1,6]. Alzheimer’s disease is the illness in the brain that causes those symptoms most often, contributing to 60 to 70 in every 100 dementia cases [1].

Alzheimer’s is physical. Two proteins build up in the wrong places: amyloid in clumps called plaques between brain cells, tau in tangles inside them. Cells lose their connections and die [2,6]. Damage usually starts in the hippocampus, which forms new memories, so recent events slip first, and can begin a decade before anyone notices [2,3,7]. Amyloid and tau are the clearest signs, not the whole explanation: aging changes, inflammation and damaged blood vessels play a part too [2].

Other illnesses cause dementia too. Vascular dementia follows damage to the brain’s blood supply. Dementia with Lewy bodies involves a different protein, with hallucinations and movement problems. Frontotemporal dementia changes behavior or language before memory [1,2]. Many people have more than one, and naming the right one matters [2,4].

How common is it?

Most figures count dementia, then estimate Alzheimer’s as a share of it. In 2021, 57 million people worldwide were living with dementia, more than 60 in every 100 of them in low-income and middle-income countries [1]. Prevalence counts how many have a condition at one time; incidence counts new cases in a year, nearly 10 million for dementia [1]. Modeling forecasts 152.8 million by 2050, with the largest increases in north Africa, the Middle East and sub-Saharan Africa [12].

More than 7 million people in the United States are living with Alzheimer’s, about 1 in 9 of those aged 65 and over [5]. Around 982,000 people in the United Kingdom are living with dementia, two in three with Alzheimer’s [6,11]. These rest on who has been diagnosed, so the real total is higher: more than a third of people over 65 with dementia in England are undiagnosed [29].

What causes it?

For most people there is no single cause. A gene is an instruction inside cells, inherited from a parent, and age, genes, health and environment all contribute [2]. Age is the strongest factor: above 65 the risk roughly doubles every five years [6,8].

Genes work in two ways. A few familial genes cause Alzheimer’s directly: an altered copy of APP, PSEN1 or PSEN2 means a person will very likely develop it before 65. That is an autosomal dominant pattern, so one copy from one parent is enough and each child has a 1 in 2 chance. It is rare, fewer than 10 in every 1,000 cases [2,8]. Risk genes are commoner and only shift the odds. Versions of APOE, especially APOE4, can make a person up to four times more likely to develop Alzheimer’s [8]. That is not a diagnosis: most carriers never develop dementia, and guidance in England says APOE testing should not be used to diagnose it [4,8].

Risk can be lowered. A standing scientific commission reported in 2024 that around 45 percent of future dementia could potentially be prevented or delayed by removing 14 risk factors, among them hearing loss, high blood pressure, smoking, physical inactivity and social isolation [13,14]. That is a population figure, not one person’s odds, and nothing on it means anyone brought this on themselves.

What are the symptoms?

Alzheimer’s affects everyone differently and changes slowly [6,7]. The commonest early signs are memory problems, especially forgetting recent conversations while older memories stay clear, difficulty concentrating or planning, trouble with words, and changes in mood [7].

Memory is not always first. Around one in ten people diagnosed at specialist clinics have a form starting with vision and spatial problems, called posterior cortical atrophy, and others start with language or behavior [6,10].

Some people first have mild cognitive impairment: more memory trouble than is normal for their age, but not enough to disrupt daily life, and not everyone with it develops Alzheimer’s [2]. Doctors then describe mild Alzheimer’s, where people get lost and struggle with bills, then moderate and severe [2].

When to seek urgent help. If someone becomes confused, drowsy, agitated or “not themselves” suddenly, over a day or two rather than over months, that is usually not Alzheimer’s getting worse. It is most often delirium, the brain’s reaction to a separate and often treatable problem: infection, pain, dehydration, constipation or a new medicine [9]. Delirium is urgent, and dementia is the biggest thing that makes it likelier [9]. Family usually notice first. Contact a doctor the same day; most people recover within days once the cause is treated [9].

How is it diagnosed?

No single test confirms Alzheimer’s; a diagnosis is built from several pieces. Getting one in good time opens the door to treatment and support, and gives time to plan money, legal matters and where to live [2,4].

It usually starts with a family doctor, who should take a history from the person and from someone who knows them well, run blood and urine tests to rule out reversible causes, and use a short memory test, though a normal score does not rule dementia out [4]. If dementia is still suspected the person is referred to a specialist memory service, which decides which illness is behind it, usually with a brain scan. Where it stays unclear, an amyloid PET scan or spinal fluid from a lumbar puncture can be tested for tau and amyloid [2,4].

Blood tests are the biggest recent change. In May 2025 the United States cleared the first one to help diagnose Alzheimer’s, for people aged 55 and over who already have symptoms [27]. In July 2025 the Alzheimer’s Association published its first guideline, recommending them to specialists to rule Alzheimer’s out, or, where accurate enough, in place of a PET scan or lumbar puncture [28]. Many sold commercially are not accurate enough [28]. They are not yet in routine health service use in the United Kingdom [29].

How is it treated?

There is no cure. Treatment eases symptoms, slows the illness a little in some people, and supports daily life [1,2].

Medicines for symptoms. Donepezil, galantamine and rivastigmine are options for mild to moderate Alzheimer’s, and slow the breakdown of acetylcholine, a chemical the brain uses for memory. Memantine works differently and is used for severe Alzheimer’s [4]. Both help with symptoms only and lose their effect over time [15].

The anti-amyloid antibodies. Lecanemab and donanemab are given by drip and clear amyloid from the brain. They are the most talked-about and most overstated treatments in Alzheimer’s. In the lecanemab trial, 1,795 people at the mild cognitive impairment or mild dementia stage were followed for 18 months; scores on an 18-point scale worsened by 1.21 points with lecanemab and 1.66 with placebo [16]. England’s health technology body summarized both as roughly 4 to 6 months of delay in moving from mild to moderate Alzheimer’s [24]. They slow decline modestly. They do not stop the illness, reverse it, restore lost memory or cure anything, and were only tested at the earliest symptomatic stages [16,17,18].

The main risk is ARIA, amyloid-related imaging abnormalities: temporary swelling in the brain, or small spots of bleeding. Usually it shows only on a scan and causes nothing; occasionally it is serious or life-threatening [18,19]. With donanemab, ARIA with swelling occurred in 24.4 percent of people treated against 1.9 percent on placebo, and three deaths in that trial were treatment related [17,33]. People with two copies of APOE4 face a much higher risk, so APOE4 testing comes first, and neither medicine is given to people on blood thinners [18,19,20,21]. Both mean regular infusions and repeat MRI scans for months [20,22,23].

Access differs sharply by country. In the United States both have full approval, and Medicare covers part of the cost for people meeting the criteria [15,18,19]. In the European Union both are authorized since 2025, only for people with one or no copy of APOE4 [22,23]. In Great Britain both are licensed, and neither is funded for National Health Service use: guidance in June 2025 found the benefits too small for the cost, and in July 2026 both evaluations were paused for commercial talks [20,21,24,25,26]. Licensed and funded are not the same thing.

Living with Alzheimer’s disease

Everyone diagnosed should have one named professional coordinating their care and a written care plan, and guidance recommends group cognitive stimulation therapy, occupational therapy, physical activity and social contact alongside any medicines [1,4]. At diagnosis, people should be told which illness they have and what to expect, that the vehicle licensing authority and car insurer must be told, and their rights at work [4]. Guidance also recommends early chances to discuss lasting power of attorney and a statement of wishes, easier while someone can lead it [4].

Nearly 13 million people in the United States care unpaid for someone with dementia, and 59 percent report high emotional strain [5]. Carers need support in their own right, including breaks and someone to talk to [1,5].

Thinking about a clinical trial?

Clinical trials test whether a treatment works and whether it is safe. In Alzheimer’s the decision is often taken by two people together.

1. Understand what the study is asking

  • what the researchers want to learn, what the treatment is compared with, and how long it lasts
  • what visits, tests and travel are involved, including drips and MRI scans
  • the known risks, and what happens at the end

2. Consider possible medical suitability

Every trial has rules about who can take part, called eligibility criteria. For an Alzheimer’s study these might include being at the mild cognitive impairment or mild dementia stage, amyloid confirmed by a scan, spinal fluid or blood test, a memory score in a set range, an APOE result, and a study partner who knows the person’s daily life.

trialport’s medifit helps people consider information related to possible medical suitability. It does not diagnose a condition, confirm eligibility or replace formal screening by the study team.

Explore Alzheimer’s disease clinical trials through trialport

3. Consider whether participation fits your life

A study can look right on paper and still be hard in practice:

  • how many visits there are, and who would travel with you
  • work, caring responsibilities and time off for both of you
  • how a long clinic day or unfamiliar place affects the days after
  • how you feel about learning genetic or amyloid results

trialport’s readifit helps people reflect on their understanding, motivation, time, routines, support, emotions and practical arrangements.

4. Ask questions before deciding

  • Why is this study being done, and what is known about the treatment?
  • What would we need to do, and how often?
  • Could I receive a placebo, a dummy treatment with no active medicine, used so results can be compared fairly? How likely is that here?
  • Would I be told my APOE or amyloid result, and what if I would rather not know?
  • What are the known risks, and how would they be watched for?
  • Who do we call between visits, and who decides whether treatment pauses?
  • Would my current medicines continue?
  • Can we leave after joining, and what happens to care?

Taking part is voluntary. A person can ask questions, speak with people they trust and choose not to participate.

Search for clinical trials at app.trialport.com.

Current research

Four areas are moving. None is a cure.

  • Better and earlier tests. Blood tests measuring tau and amyloid have reached clinical use in some countries, and work is under way to bring them into the health service [27,28,29].
  • Amyloid questioned as well as targeted. Two other antibodies that cleared amyloid, gantenerumab and solanezumab, did not slow decline [31,32]. Amyloid is not the whole answer.
  • Longer use of the licensed antibodies. Extension studies in 2025 suggested benefit continues past 18 months, with ARIA rates falling after the first year, and lecanemab can now be given at home weekly in the United States [30].
  • Reducing risk. A large United States study in 2025 found that healthy habits combined protect thinking in older adults at risk [5].

Study status checked: 3 August 2026. Research moves quickly, so this will date. For current information, search at app.trialport.com.

Support and further information

In the United Kingdom, Alzheimer’s Society runs a support line staffed by dementia advisers [6], Alzheimer’s Research UK has an information line and guides to each type of dementia [10], and Dementia UK provides specialist nurses.

In the United States, the Alzheimer’s Association runs a free 24-hour helpline in more than 200 languages [5], and the National Institute on Aging publishes plain guides [2].

Coverage is thinner elsewhere, where most growth is expected [12]. The World Health Organization publishes iSupport, a free program for carers [1].

Well-known people with Alzheimer’s disease

Former United States president Ronald Reagan announced his own diagnosis in a handwritten letter to the American public on 5 November 1994, saying he and his wife hoped to raise awareness [34].

The novelist Sir Terry Pratchett was diagnosed in December 2007, at 59, with a rare form of Alzheimer’s. He spoke about it on stage in 2008, became a patron of Alzheimer’s Research UK, donated more than a million dollars and campaigned for research funding until he died in 2015 [35,36].

Neither experience predicts anyone else’s.

Questions people often ask

What is the difference between dementia and Alzheimer’s disease?
Dementia is the set of symptoms; Alzheimer’s is the illness that causes them most often [1,6].

Is Alzheimer’s inherited?
Usually not. Fewer than 10 in every 1,000 people with Alzheimer’s have it because of an inherited gene that causes it directly; risk genes such as APOE4 only shift the odds [8].

Do lecanemab and donanemab work, and can I get them?
They slow decline modestly in early Alzheimer’s, roughly 4 to 6 months of delay in moving from mild to moderate, and carry a risk of brain swelling or bleeding [16,17,24,33]. They do not stop or reverse it. Both are available in the United States and the European Union within limits; in Great Britain both are licensed but not funded for health service use [20,21,22,23].

My relative got much worse over two days. Is this the Alzheimer’s?
Probably not. A change that fast is usually delirium from something treatable, often an infection, and needs same-day help [9].

How long do people live after a diagnosis?
On average four to eight years for people diagnosed at 65 or over, and some as long as 20, much of it lived well [1,5].

Sources

  1. World Health Organization. Dementia. Fact sheet, 3 July 2026. https://www.who.int/news-room/fact-sheets/detail/dementia Accessed 3 August 2026.
  2. National Institute on Aging (NIA), National Institutes of Health. Alzheimer’s Disease Fact Sheet. Content reviewed 5 April 2023. https://www.nia.nih.gov/health/alzheimers-and-dementia/alzheimers-disease-fact-sheet Accessed 3 August 2026.
  3. National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health. Alzheimer’s Disease. https://www.ninds.nih.gov/health-information/disorders/alzheimers-disease Accessed 3 August 2026.
  4. National Institute for Health and Care Excellence (NICE). NICE guideline NG97 on dementia: recommendations. Published 20 June 2018. https://www.nice.org.uk/guidance/ng97/chapter/Recommendations Accessed 3 August 2026. (Cited by guideline number and topic; see the fact-checking note in section 27.)
  5. Alzheimer’s Association. Alzheimer’s Disease Facts and Figures: quick facts, prevalence, mortality and morbidity, caregiving, workforce, costs and special report. 2026 report page. https://www.alz.org/alzheimers-dementia/facts-figures Accessed 3 August 2026.
  6. Alzheimer’s Society. What is Alzheimer’s disease? Page dated 13 November 2024. https://www.alzheimers.org.uk/about-dementia/types-dementia/alzheimers-disease Accessed 3 August 2026.
  7. Alzheimer’s Society. Symptoms of Alzheimer’s disease. https://www.alzheimers.org.uk/about-dementia/types-dementia/alzheimers-disease-symptoms Accessed 3 August 2026.
  8. Alzheimer’s Society. Risk factors for Alzheimer’s disease. https://www.alzheimers.org.uk/about-dementia/types-dementia/who-gets-alzheimers-disease Accessed 3 August 2026.
  9. Alzheimer’s Society. Delirium: symptoms, diagnosis and treatment. https://www.alzheimers.org.uk/get-support/living-with-dementia/delirium Accessed 3 August 2026.
  10. Alzheimer’s Research UK. Posterior cortical atrophy. Information updated April 2025. https://www.alzheimersresearchuk.org/dementia-information/types-of-dementia/posterior-cortical-atrophy/ Accessed 3 August 2026.
  11. Alzheimer’s Research UK. Dementia Statistics Hub. https://www.alzheimersresearchuk.org/dementia-statistics/ Accessed 3 August 2026.
  12. GBD 2019 Dementia Forecasting Collaborators. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. The Lancet Public Health. 2022;7(2):e105-e125. doi:10.1016/S2468-2667(21)00249-8. Published abstract retrieved through the Europe PMC web service, https://europepmc.org/article/MED/34998485 Accessed 3 August 2026.
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  14. Alzheimer Europe. 2024 Lancet Commission underscores the potential for dementia risk reduction, identifying 14 modifiable risk factors across the life course. News, 31 July 2024. https://www.alzheimer-europe.org/news/2024-lancet-commission-underscores-potential-dementia-risk-reduction-identifying-14-modifiable Accessed 3 August 2026.
  15. National Institute on Aging (NIA). How Is Alzheimer’s Disease Treated? https://www.nia.nih.gov/health/alzheimers-treatment/how-alzheimers-disease-treated Accessed 3 August 2026.
  16. van Dyck CH, Swanson CJ, Aisen P, et al. Lecanemab in Early Alzheimer’s Disease. New England Journal of Medicine. 2023;388(1):9-21. doi:10.1056/NEJMoa2212948. Published abstract retrieved through the Europe PMC web service, https://europepmc.org/article/MED/36449413 Accessed 3 August 2026.
  17. Sims JR, Zimmer JA, Evans CD, et al, TRAILBLAZER-ALZ 2 Investigators. Donanemab in Early Symptomatic Alzheimer Disease: The TRAILBLAZER-ALZ 2 Randomized Clinical Trial. JAMA. 2023;330(6):512-527. doi:10.1001/jama.2023.13239. Published abstract retrieved through the Europe PMC web service, https://europepmc.org/article/MED/37459141 Accessed 3 August 2026.
  18. United States Food and Drug Administration (FDA). FDA Converts Novel Alzheimer’s Disease Treatment to Traditional Approval. Press announcement, 6 July 2023. https://www.fda.gov/news-events/press-announcements/fda-converts-novel-alzheimers-disease-treatment-traditional-approval Accessed 3 August 2026.
  19. United States Food and Drug Administration (FDA). FDA Approves Treatment for Adults with Alzheimer’s Disease (Kisunla, donanemab-azbt). https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-treatment-adults-alzheimers-disease Accessed 3 August 2026.
  20. Medicines and Healthcare products Regulatory Agency (MHRA). Lecanemab licensed for adult patients in the early stages of Alzheimer’s disease. Press release, 22 August 2024. https://www.gov.uk/government/news/lecanemab-licensed-for-adult-patients-in-the-early-stages-of-alzheimers-disease Accessed 3 August 2026.
  21. Medicines and Healthcare products Regulatory Agency (MHRA). Donanemab licensed for early stages of Alzheimer’s disease in adult patients who have one or no copies of apolipoprotein E4 gene. Press release, 23 October 2024. https://www.gov.uk/government/news/donanemab-licensed-for-early-stages-of-alzheimers-disease-in-adult-patients-who-have-one-or-no-copies-of-apolipoprotein-e4-gene Accessed 3 August 2026.
  22. European Medicines Agency (EMA). Leqembi (lecanemab): medicine overview. Marketing authorisation valid throughout the EU from 15 April 2025. https://www.ema.europa.eu/en/medicines/human/EPAR/leqembi Accessed 3 August 2026.
  23. European Medicines Agency (EMA). Kisunla (donanemab): medicine overview. Marketing authorisation valid throughout the EU from 24 September 2025. https://www.ema.europa.eu/en/medicines/human/EPAR/kisunla Accessed 3 August 2026.
  24. National Institute for Health and Care Excellence (NICE). Final draft guidance finds benefits of 2 Alzheimer’s treatments remain too small to justify the additional cost to the NHS. News, 19 June 2025. https://www.nice.org.uk/news/articles/the-benefits-of-alzheimers-treatments-donanemab-and-lecanemab-remain-too-small-to-justify-the-additional-costs-says-nice-in-final-draft-guidance Accessed 3 August 2026.
  25. National Institute for Health and Care Excellence (NICE). Lecanemab for treating mild cognitive impairment or mild dementia caused by Alzheimer’s disease [ID4043]: project information and timeline, including the note of 29 July 2026 pausing the evaluation. https://www.nice.org.uk/guidance/indevelopment/gid-ta11220 Accessed 3 August 2026.
  26. National Institute for Health and Care Excellence (NICE). Donanemab for treating mild cognitive impairment or mild dementia caused by Alzheimer’s disease [ID6222]: project information and timeline, including the note of 30 July 2026 pausing the evaluation. https://www.nice.org.uk/guidance/indevelopment/gid-ta11221 Accessed 3 August 2026.
  27. United States Food and Drug Administration (FDA). FDA Clears First Blood Test Used in Diagnosing Alzheimer’s Disease. Press announcement, 16 May 2025. https://www.fda.gov/news-events/press-announcements/fda-clears-first-blood-test-used-diagnosing-alzheimers-disease Accessed 3 August 2026.
  28. Alzheimer’s Association. Alzheimer’s Association Releases Its First Clinical Practice Guideline for Blood-Based Biomarker Tests. Press release, 29 July 2025, reporting the guideline published in Alzheimer’s & Dementia. https://aaic.alz.org/releases-2025/clinical-practice-guideline-blood-based-biomarkers.asp Accessed 3 August 2026.
  29. Alzheimer’s Society. Blood Biomarker Challenge: the blood test set to ‘revolutionise’ dementia diagnosis. https://www.alzheimers.org.uk/what-we-do/researchers/news/blood-biomarker-tests Accessed 3 August 2026.
  30. Alzheimer’s Association. Alzheimer’s Association Welcomes FDA Action Approving Leqembi Weekly Subcutaneous Maintenance Dosing. News, 29 August 2025. https://www.alz.org/news/2025/fda-action-approving-leqembi-subcutaneous-maintenance-dosing Accessed 3 August 2026.
  31. Bateman RJ, Smith J, Donohue MC, et al, GRADUATE I and II Investigators and the Gantenerumab Study Group. Two Phase 3 Trials of Gantenerumab in Early Alzheimer’s Disease. New England Journal of Medicine. 2023;389(20):1862-1876. doi:10.1056/NEJMoa2304430. Published abstract retrieved through the Europe PMC web service, https://europepmc.org/article/MED/37966285 Accessed 3 August 2026.
  32. Sperling RA, Donohue MC, Raman R, et al, A4 Study Team. Trial of Solanezumab in Preclinical Alzheimer’s Disease. New England Journal of Medicine. 2023;389(12):1096-1107. doi:10.1056/NEJMoa2305032. Published abstract retrieved through the Europe PMC web service, https://europepmc.org/article/MED/37458272 Accessed 3 August 2026.
  33. Zimmer JA, Ardayfio P, Wang H, et al. Amyloid-Related Imaging Abnormalities With Donanemab in Early Symptomatic Alzheimer Disease: Secondary Analysis of the TRAILBLAZER-ALZ and ALZ 2 Randomized Clinical Trials. JAMA Neurology. 2025;82(5):461-469. doi:10.1001/jamaneurol.2025.0065. Published abstract retrieved through the Europe PMC web service, https://europepmc.org/article/MED/40063015 Accessed 3 August 2026.
  34. Ronald Reagan Presidential Library and Museum, National Archives and Records Administration. Reagan’s Letter Announcing his Alzheimer’s Diagnosis, 5 November 1994. https://www.reaganlibrary.gov/reagans/ronald-reagan/reagans-letter-announcing-his-alzheimers-diagnosis Accessed 3 August 2026.
  35. Alzheimer’s Research UK. Sir Terry Pratchett: A watershed moment for dementia. 11 February 2017, reproducing his 2008 conference speech. https://www.alzheimersresearchuk.org/news/sir-terry-pratchett-a-watershed-moment-for-dementia/ Accessed 3 August 2026.
  36. Alzheimer’s Research UK. Sir Terry Pratchett: The fantasy author’s legacy to dementia research. 10 February 2017. https://www.alzheimersresearchuk.org/news/sir-terry-pratchett-the-fantasy-authors-legacy-to-dementia-research/ Accessed 3 August 2026.
  37. National Library of Medicine, Clinical Table Search Service. ICD-10-CM codes for Alzheimer’s disease: G30.0, G30.1, G30.8 and G30.9. https://clinicaltables.nlm.nih.gov/apidoc/icd10cm/v3/doc.html Accessed 3 August 2026.

Review information

Written by: trialport editorial team
Reviewed by: Keith Berelowitz, Founder and CEO, trialport
Reviewed on: 3 August 2026
Next review due: 3 August 2027
References last checked: 3 August 2026

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