Understanding treatment options

Memory and thinking changes typically develop gradually and over a long time. At first, it might be forgetting appointments or losing track of conversations. For some people, these changes turn out to be part of normal aging. For others, these changes happen more often or form a pattern, and they may be early signs of mild cognitive impairment or dementia. Learning that you or someone you love may be facing mild cognitive impairment or dementia can be difficult. You may have questions such as: What treatments are available? Do medications help? What else can we do right now?

These conditions can change how someone feels and acts around others. Getting the right treatment can help. Early diagnosis is very important because some newer treatments are approved only for the early stages of the disease. This article discusses current medication and non-medication treatments for mild cognitive impairment and dementia.

Medications for Mild Cognitive Impairment and dementia

Drugs that target Alzheimer’s disease

Alzheimer’s disease is the most common form of dementia, accounting for 60-80% of cases. For this reason, most medications currently available, or in development, are designed to treat Alzheimer’s disease. Two newer medications, lecanemab (Leqembi) and donanemab (Kisunla), help clear a harmful protein called amyloid, which clumps together into plaques in the brains of people with Alzheimer’s disease. They are approved for people with mild cognitive impairment or mild dementia due to Alzheimer’s disease. Before treatment, doctors confirm that amyloid is present using a PET scan, a spinal fluid test, or, in some cases, a blood test. These treatments are not suitable for people who take blood thinners such as Warfarin, or those with certain genes (two copies of APOE e4).  

In large clinical trials, removing amyloid slowed the decline in memory and thinking by about 20% to 35% over 18 months in people with early Alzheimer’s disease. People who received these drugs also had less decline in their ability to manage daily activities than those who received a placebo (an inactive treatment).

However, these drugs are not approved for people with moderate or severe dementia because they have not been shown to help at those stages. That’s why early diagnosis and routine cognitive testing are important. These drugs do not stop or reverse memory loss. Instead, they slow decline, and their benefits build gradually over time.

Donanemab is given as an IV infusion once a month, and it may be stopped once scans show that amyloid has been cleared. Lecanemab can be given as an IV infusion every 2 weeks, or as a weekly injection under the skin that can be done at home. Treatment requires ongoing monitoring. Side effects can include reactions during or after an infusion or injection (such as fever, chills, or flu-like symptoms) and temporary brain swelling or small brain bleeds, called amyloid-related imaging abnormalities (ARIA). ARIA shows up on brain scans in about 1 in 8 to 1 in 4 people treated. Most people with ARIA have no symptoms, but some have headache, confusion, dizziness, or vision changes, and serious cases are rare. For safety, regular brain MRIs are needed to watch for these risks, particularly in the first months of treatment. People who carry two copies of a gene called APOE4 have a higher risk of ARIA, which is why genetic testing is recommended before starting treatment, and a decision is made whether a treatment is considered appropriate. Not everyone can take these medications. Factors such as other medical conditions and the use of blood thinners play a role in determining whether this kind of treatment is appropriate.

Medications that treat symptoms

Other medications focus on helping with symptoms, rather than slowing disease progression. These treatments can help some people function better day to day, but they do not change the underlying cause of the disease. Responses and side effects may be different from patient to patient.

• Cholinesterase inhibitors, such as donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), help the brain keep more of a chemical called acetylcholine. This chemical is important for memory and thinking. They are approved for Alzheimer’s disease, and rivastigmine is also approved for dementia due to Parkinson’s disease. Doctors sometimes prescribe them for Lewy body dementia or vascular dementia as well. They have not been shown to keep mild cognitive impairment from progressing to dementia. Common side effects include nausea, vomiting, diarrhea, appetite loss, muscle cramps, or sleep problems.
• Memantine (Namenda) works differently, by regulating glutamate, a brain chemical involved in memory and learning. It is approved for moderate to severe Alzheimer’s disease and is sometimes combined with donepezil in a single capsule (Namzaric). Common side effects include dizziness, headache, confusion, or constipation.

Treating other conditions that affect memory and thinking

Other health problems can make dementia symptoms worse. For example, depression, sleep problems, hearing loss, thyroid problems, low vitamin B12, or side effects from other medications can all worsen memory and thinking. Identifying and treating these issues with the right medications or therapies can help people feel better. Agitation and sleep problems are also common in dementia. Brexpiprazole (Rexulti) and dextromethorphan-bupropion (Auvelity) are approved to treat agitation linked to Alzheimer’s dementia, and suvorexant (Belsomra) is approved for insomnia in people with Alzheimer’s disease. Your doctor can explain the benefits and risks of each. When considering these conditions, doctors are careful to avoid medications that can have negative effects on memory or thinking.

Non-medication treatments

Not everyone prefers to take medicine. The good news is that non-drug treatments can help your brain and your body, too.

Lifestyle changes and habits

Small changes in everyday life can make a big difference. In fact, experts estimate that addressing 14 risk factors, such as high blood pressure, hearing loss, physical inactivity, and smoking, could prevent or delay nearly half (about 45%) of dementia cases. Healthy habits may also help people with memory or thinking problems stay independent longer. These habits include:

• Move every day: Exercise helps with strength, balance, and brain health. Try to get at least 30 minutes of moderate activity 5 days a week, plus muscle-strengthening activities 2 days a week. This can be brisk walking, dancing, yoga, or light weights.
• Get good rest: Good sleep helps the brain rest, clear waste, and stay healthy. Aim for 7 to 9 hours a night. Avoid caffeine in the afternoon, keep your room cool and quiet, and avoid screens before bed. If you snore loudly or feel very tired during the day, ask your doctor about sleep apnea.
• Eat green and lean: Eat lots of fruits, vegetables, whole grains, and lean proteins like fish or beans. Brain-healthy eating patterns, such as the Mediterranean and MIND diets, include fish like salmon and sardines, which are rich in omega-3 fatty acids.
• Keep your health in check: Your brain and body work as a team. Get regular checkups, including hearing, vision, and dental exams. Keep blood pressure, blood sugar, and cholesterol under control, use hearing aids if you need them, and take your medications as prescribed. Don’t smoke, limit alcohol, and protect your head from injury by wearing a seat belt or helmet.
• Build your village: Loneliness can harm your brain health. Talk to friends, join a club, or call family members often.
• Learn something new: New experiences help keep your brain sharp. Try puzzles, reading, playing cards, or learning a new skill or language. Whilst it is good to learn more about the things you already know some things about, the important thing is to challenge your brain. Try to learn new skills rather than only build on what you know.
• Be mindful about your mental health: Depression, anxiety, and stress can worsen memory or thinking. Deep breathing, meditation, or talking to a counselor or therapist can help manage feelings of stress and anxiety. If you feel sad or down most days, talk to your doctor, because depression is treatable.
• Stay true to your purpose: Doing things that matter to you is a valuable exercise for your brain and can improve your mental health.  Do what’s meaningful to you, whether it’s helping others or spending time with family.  

For more detailed information on lifestyle changes to support your brain health, view everyday habits for a healthy brain.

Therapies that help

There are also many non-drug therapies that can help people with dementia feel more relaxed and connected. These activities may reduce agitation, restlessness, and anxiety, and help people with dementia enjoy life more. Examples include:

• Cognitive stimulation therapy (group activities that gently engage thinking and memory)
• Reminiscence therapy (sharing memories, photos, and music from the past)
• Music therapy
• Pet therapy
• Art therapy (like painting or drawing)
• Aromatherapy
• Massage therapy
• Light exercise
• Watching videos of family and friends

Making the home safe

Simple changes around the house can help someone with dementia live more safely:

• Reduce clutter and loud noises
• Lock up or hide dangerous items like sharp objects, medications, firearms, or car keys
• Improve lighting, remove loose rugs, and add grab bars to help prevent falls
• Set up a daily routine
• Use safety alarms or cameras if needed

Occupational therapists can help families figure out the best ways to make a home safe and comfortable.

Importance of early diagnosis

Early diagnosis is key. The newest Alzheimer’s treatments are approved only for people in the early stages of the disease. The sooner you know, the more you can do to help the brain and plan for the future.

Regular check-ups can help catch problems early. New digital tests and tools using AI may catch small changes in memory or thinking that traditional paper-based tests might miss. FDA-cleared blood tests can also help doctors check for signs of Alzheimer’s disease in people who have symptoms.

If you or someone you love is having memory or thinking difficulties, don’t wait. Talk to your doctor. The sooner you get help, the more options you have to manage the condition and live well.

References

Alzheimer’s Association. Alzheimer’s Association statement on FDA clearance of Elecsys pTau217 blood test for Alzheimer’s diagnosis. Published August 24, 2026. https://www.alz.org/news/2026/fda-clearance-elecsys-ptau217-blood-test-alzheimers. Accessed September 24, 2026.

Alzheimer’s Association. Medications for memory, cognition and dementia-related behaviors. https://www.alz.org/alzheimers-dementia/treatments/medications-for-memory. Accessed September 24, 2026.

Alzheimer’s Association. What is Alzheimer’s disease? https://www.alz.org/alzheimers-dementia/what-is-alzheimers. Accessed September 24, 2026.

Alzheimer’s Society. Medication for dementia symptoms. https://www.alzheimers.org.uk/about-dementia/treatments/dementia-medication/medication-dementia-symptoms. Accessed September 24, 2026.

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Centers for Disease Control and Prevention. Older adult activity: an overview. https://www.cdc.gov/physical-activity-basics/guidelines/older-adults.html. Accessed September 24, 2026.

Eisai Inc. FDA approves LEQEMBI IQLIK (lecanemab-irmb) subcutaneous injection as an initiation dose for early Alzheimer’s disease. Published July 13, 2026. https://media-us.eisai.com/2026-07-13-FDA-Approves-LEQEMBI-IQLIK-R-lecanemab-irmb-Subcutaneous-Injection-as-an-Initiation-Dose-for-Early-Alzheimers-Disease. Accessed September 24, 2026.

Eli Lilly and Company. FDA approves updated label for Lilly’s Kisunla (donanemab-azbt) with new dosing in early symptomatic Alzheimer’s disease. Published July 9, 2025. https://investor.lilly.com/news-releases/news-release-details/fda-approves-updated-label-lillys-kisunla-donanemab-azbt-new. Accessed September 24, 2026.

Linus Health. Why new Alzheimer’s drugs rely on early diagnosis & screening. Linus Health Blog. Published July 19, 2023. https://linushealth.com/blog/why-new-alzheimers-drugs-rely-on-early-diagnosis-screening. Accessed September 24, 2026.

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Mayo Clinic Staff. Dementia: diagnosis and treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/dementia/diagnosis-treatment/drc-20352019. Accessed September 24, 2026.

National Institute on Aging. Sleep and older adults. https://www.nia.nih.gov/health/sleep/sleep-and-older-adults. Accessed September 24, 2026.

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