Although half of all dementias are caused by Alzheimer’s disease, it is critical that other possible causes for impaired functioning in the elderly patient be evaluated and ruled out before caregivers and/or family members attempt to undertake enhancement programs. As the public becomes more aware of Alzheimer’s disease, the danger of non­professionals making a diagnosis increases, and with it, well-intentioned but often inappropriate attempts or suggestions at management. If appropriate medical investigation is conducted, this should not be a problem, since a diagnosis of Alzheimer’s disease in part depends upon a systematic exclusion of other dementing diseases, some of which are treatable or reversible.Even where Correct diagnosis is made, the caregiver should be alert to changes in the patient’s thinking, speech, or emotions that may not be a true component of Alzheimer’s disease. In some cases, such changes may reflect other, modifiable conditions, which, if taken into account, would reduce some of the confusion or disorganization that occurs in the demented patient. For example, demented individuals are vulnerable to delirium, which typically can be recognized as a sudden and obvious change in the patient’s normal mental functioning. Delirium may have symptoms that are very similar to those of Alzheimer’s disease, e.g., impaired alertness, slow and confused thinking, and difficulties in shifting or maintaining a focus of attention. However, these symptoms can result from various physical ailments or reactions to medicines.

In addition, depression mayor may not be present in the Alzheimer patient at a particular point in time. When present, depression can make impaired memory function even worse, reduce the patients interest in the surrounding environment and in others, further compound difficulties in regulation of sleep, and even result in a full-scale withdrawal into a completely incapacitated vegetative state.

These considerations reflect that while Alzheimer’s disease is progressive, the rate of progression and the way that the impairments show themselves may vary greatly across individuals and may be influenced by factors such as depression and toxic drug reactions. Though many strategies will be discussed here, it will be important to keep in mind that any management approach involves frequently changing interactions between the Alzheimer sufferer and the relative or caregiver. This is because the condition may vary from day to day and worsen over time.

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