What medications treat early-stage Alzheimer’s disease?

Alzheimer's disease is a neurodegenerative disorder that causes dementia, or a decline in memory, thinking, and behavior.

Although the causes are not fully understood, Alzheimer's disease is associated with the buildup of abnormal protein deposits in the brain. These deposits are called amyloid plaques and tau tangles. These deposits damage the brain, causing neurons (brain cells) to die off. However, it’s important to remember that the exact mechanisms of Alzheimer's disease are not fully understood, and research is ongoing.

Healthcare providers recommend starting treatment for Alzheimer's disease as soon as possible after diagnosis. Alzheimer's disease is a progressive condition, or a condition that becomes more severe with time. Typically, the earlier a person takes steps to protect the brain, the greater the opportunity for better treatment outcomes. Certain therapies work better when used in the early stages of the disease.

Here, we look at the medications often used in the treatment of early-stage Alzheimer’s disease.

What is early-stage Alzheimer’s disease?

Alzheimer’s disease is staged by the extent of damage to the brain and the symptoms a person is experiencing. Early-stage Alzheimer’s disease includes mild cognitive impairment (MCI) and mild dementia:

Mild cognitive impairment (MCI)

At this stage, a person experiences changes in memory and thinking. These changes are greater than expected for a person of their age. A person may misplace objects, forget appointments, or have difficulty remembering words, but symptoms do not impact daily life to the same degree as dementia, and a person can remain independent. MCI increases the risk of having dementia, but not everyone with MCI will develop dementia.

Mild dementia

At this stage, a person experiences changes to memory and thinking that will interfere with some aspects of daily functioning and activities. A person with mild dementia may have difficulty with complex thinking or problem solving, finding their way around, remembering recent events, and organizing thoughts. Personality and behavioral changes can also occur at this stage.

What medications are used to treat early-stage Alzheimer's disease?

A treatment plan for early-stage Alzheimer's disease will include medications. The specific medications recommended by a healthcare team will depend on the person being treated. Medication options can include:

Cholinesterase inhibitors

Cholinesterase inhibitors are medications that prevent the breakdown of a neurotransmitter called acetylcholine. Neurotransmitters are chemical messengers that enable neurons to communicate with other neurons. People with Alzheimer’s disease have lower amounts of acetylcholine in their brains. Cholinesterase inhibitors help boost the amount of acetylcholine, which helps improve thinking and memory. However, these drugs do not slow the progression of Alzheimer’s disease.

Disease-modifying therapies

Disease-modifying therapies are a more recent development in the treatment of Alzheimer's disease, with drugs approved in 2023 and 2024 (and other drugs under development). Also known as anti-amyloid therapies, these are drugs that reduce amyloid plaques in the brain in order to help slow the progression of the disease. The drugs that are currently available are approved for people with mild cognitive impairment and mild dementia. Not everyone will be a candidate for these therapies, and the potential for side effects and costs are important topics to discuss with a healthcare provider.

Other parts of a treatment plan

In addition to medications, there are other aspects of treating early Alzheimer's disease that should be discussed with a healthcare provider. Adopting changes to diet, exercising regularly, activities that are cognitively stimulating (like reading and puzzles), and social engagement can help you get the most out of treatment and maintain good overall health. A person should also reduce alcohol intake to a minimum, stop smoking (if they smoke), and manage any coexisting health conditions, such as cardiovascular disease, diabetes, vision loss, and hearing loss.

Also worth considering are supportive therapies, such as working with a mental health professional or participating in a support group where you can connect with other people who are living with Alzheimer's disease.