Dementia care starts with an accurate diagnosis, honest expectations about treatment, and a plan for the daily work of caregiving. This guide answers the questions people search for most: what dementia is, how it is diagnosed today, whether new drugs help, what care costs, and where to get reliable help.
Dementia is not a single disease. It is a set of symptoms — loss of thinking, memory, and reasoning severe enough to disrupt daily life — and it is not a normal part of aging, according to the National Institute on Aging. Alzheimer's is the most common cause, but not the only one.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- What counts as dementia, and how common is it?
- How is dementia diagnosed now?
- Do the new Alzheimer's drugs actually work?
- What does dementia care cost, and who pays?
- Where can caregivers start?
- Frequently Asked Questions
What counts as dementia, and how common is it?
dementia describes a decline in cognitive function that interferes with everyday tasks like managing money, cooking, or holding a conversation. Occasional forgetfulness is not dementia; the change must be persistent and disabling. Different diseases cause it, including Alzheimer's, vascular dementia, Lewy body dementia, and frontotemporal dementia.
Age is the largest risk factor. About one-third of people age 85 and older have some form of dementia, and roughly 57 million people worldwide had dementia in 2021, a figure the World Health Organization projects will nearly triple by 2050. In the United States, the scale recently crossed a milestone. More than 7.2 million Americans age 65 and older now live with Alzheimer's, the first time that count has passed 7 million, per the Alzheimer's Association's 2025 report.
How is dementia diagnosed now?
Diagnosis combines a medical history, cognitive testing, a neurological exam, and sometimes brain imaging or lab work to rule out other causes. There is no single test that confirms dementia in a doctor's office. For Alzheimer's specifically, doctors look for evidence of amyloid, a protein that builds up in the brain. Confirming amyloid once required a PET scan or a spinal fluid (CSF) sample.
That changed in 2025. The FDA cleared the first blood test for Alzheimer's diagnosis on May 16, 2025 — Fujirebio's Lumipulse plasma ratio, for symptomatic adults 55 and older. This blood test is a less invasive option, but note its limits. It is intended for people who already have symptoms, not for screening healthy adults, and a positive result still needs to be interpreted by a clinician alongside the full evaluation.
Do the new Alzheimer's drugs actually work?
Two anti-amyloid antibody drugs now have full FDA approval: lecanemab (Leqembi) in July 2023 and donanemab (Kisunla) in July 2024. Both are approved only for early symptomatic Alzheimer's — mild cognitive impairment or mild dementia — in people with confirmed amyloid. They are not approved for moderate or severe stages. Set expectations carefully.
These drugs slow decline modestly; lecanemab reduced decline by about 27% over 18 months, according to the Alzheimer's Association. They do not cure, stop, or reverse the disease. The main safety concern is ARIA, or amyloid-related imaging abnormalities — brain swelling or small bleeds. Stanford Health Care reports ARIA in roughly 12–35% of treated patients versus 3–13% on placebo. risk is higher for carriers of the APOE4 gene, especially those with two copies, so baseline genetic testing and repeated monitoring MRIs are required.
- Eligibility check: early-stage diagnosis (MCI or mild dementia)
- Confirmed amyloid by PET, CSF, or an approved test
- APOE4 genetic testing before starting
- Ability to attend regular monitoring MRIs
What does dementia care cost, and who pays?
Costs fall into two categories: medical treatment and long-term care. For the new drugs, Medicare Part B covers Leqembi for eligible early-stage patients with confirmed amyloid who enroll in a CMS registry. The list price runs about $26,500 per year, and patients typically owe roughly 20% coinsurance unless they have supplemental coverage. The larger financial picture is caregiving.
In 2024, about 11.5 million unpaid caregivers provided roughly 19 billion hours of care valued at over $413 billion, per the Alzheimer's Association. Total dementia care costs are projected at $384 billion for 2025. Much of this burden is invisible because it is unpaid — family members cutting work hours, managing medications, and providing supervision. When budgeting, plan for both drug coinsurance and the practical costs of home care, respite, or eventual residential care.
Where can caregivers start?
Begin with a clear diagnosis from a primary care doctor or neurologist, then build a care plan around the person's current abilities. Reliable, non-commercial information helps you avoid misinformation and false cures.
A trustworthy starting point is the National Institute on Aging's overview, What Is Dementia? Symptoms, Types, and Diagnosis. It explains the types, the diagnostic process, and what to expect in plain language.
- Confirm the diagnosis and the specific type of dementia
- Ask whether early-stage drug treatment is appropriate and safe given APOE4 status
- Review Medicare coverage and out-of-pocket costs before starting any drug
- Line up respite care early, before caregiver burnout sets in
Frequently Asked Questions
Can the new blood test tell me if I'll get Alzheimer's before symptoms start?
No. The FDA-cleared Lumipulse blood test is for adults 55 and older who already have symptoms, not for screening people without cognitive problems.
Are lecanemab and donanemab a cure?
No. They slow decline modestly in early-stage Alzheimer's — lecanemab by about 27% over 18 months — but do not stop or reverse the disease.
Why is genetic testing required before starting these drugs?
APOE4 carriers, especially those with two copies, face higher risk of ARIA (brain swelling or bleeding), so testing guides safety monitoring.
