Alzheimer’s Disease: The Long Goodbye

By Mental Health Matters Team

Alzheimer’s Disease exerts a terrible toll on society.  In economic terms alone, Alzheimer’s and other dementias will cost over $800 billion just in 2026.  Beyond the financial cost, Alzheimer’s causes an immeasurable loss of identity and meaning for those living with the disease, while their loved ones face grief, loss, and the demands of caregiving. What can be done to reduce our risk for Alzheimer’s? How is Alzheimer’s diagnosed? From here we will move on to treatment and support options as we also share some testimonials from families living with “the Long Goodbye” of Alzheimer’s Disease. 

Reducing risk: 

There are some conditions whose biological causes are well understood and supported by research. Lung cancer, for example, is linked to smoking; The risk of cervical cancer developing is reduced with regular pap smears and HPV vaccines.  Causes of Alzheimer’s are more complex. 

Alzheimer’s risk increases with age, being female, a family history of the disease, and conditions such as Trisomy 21 (Down syndrome). Rates are also higher among Black Americans, reflecting disparities similar to those seen in high blood pressure and diabetes.

Maps showing the prevalence of these conditions and Alzheimer’s often highlight many of the same neighborhoods—communities that were redlined decades ago and still bear the effects of systemic racism.

What’s good for the heart is also good for the brain. The same habits that offer protection against heart attacks and stroke also prevent Alzheimer’s disease. 

• Limit saturated fats and highly processed and high-carb foods (e.g. the Mediterranean diet)
• Control blood pressure and blood sugar
• Do not smoke
• Consume little or no alcohol
• Stay physically, mentally, and socially active.  One specific example of mental engagement is doing crossword puzzles.  Crossword puzzles seem to delay the onset of symptoms of Alzheimer’s and improve cognition. 
• Avoid head injury (eg, use of seatbelts, wear helmets on motorbikes or bicycles, scooters, etc.)

Protect Vision, Hearing, and Social Connection

Healthy vision and hearing also support brain health. Hearing loss is associated with an increased risk of dementia, possibly because the brain must devote more resources to processing sound, leaving fewer resources for memory and reasoning.

Hearing loss can also reduce social engagement and intellectual stimulation. Identifying and treating it may therefore be an important preventive step.

Vitamins and Supplements

Unless a vitamin or mineral deficiency has been identified, supplements may not help prevent Alzheimer’s disease. Some evidence suggests that B vitamins and vitamin D may play a role, so obtaining these nutrients through a balanced diet is recommended. When testing confirms a deficiency, supplements such as vitamin B12, folate, or vitamin D may support both mental and physical well-being.

Vaccines and Dementia Risk

Growing evidence suggests that vaccines against several infections may also reduce the risk of Alzheimer’s disease. Vaccines associated with this possible added protection include:

• Shingles (Shingrix)
• Tetanus, diphtheria, and pertussis (Tdap)
• Pneumococcal disease
• Influenza

This possible protection may result, in part, from reduced inflammation in the brain.

How is Alzheimer’s diagnosed?

No single test definitively diagnoses Alzheimer’s, although blood markers and other tests are being developed. Diagnosis combines discussion with your doctor and tests to rule out other causes of cognitive decline.

• Medical history: Health conditions, daily routines, and changes noticed by you or those close to you.
• Physical exam: Checks for vision or hearing loss, sensory changes, weakness, coordination problems, and conditions such as Parkinson’s disease.
• Cognitive screening: Brief tests of memory, problem-solving, and language, such as recalling three words or drawing a clock.
• Lab tests: Screens for treatable causes such as anemia, kidney or liver disease, low thyroid function, infections, and vitamin deficiencies.
• Brain imaging: A CT scan or MRI may be needed in some cases.

A detailed neuropsychological evaluation may also assess attention, memory, and functional decline to help confirm the diagnosis.

Why the diagnosis matters

Ruling out other causes of memory loss or behavior change in someone who may have dementia is essential.  Many non-Alzheimer’s conditions, such as hypothyroidism, anemia, and vitamin B12 deficiency, can be treated and effectively managed and that leads to improved or restored function.  Once Alzheimer’s is left as the clinical diagnosis, that enables the treatment team including the individual and their family to select the support options best suited to them.  Doing this early in the disease course helps the individual and family better address long-term care, finances, and legal issues that may arise.

Conclusion

Receiving and managing an Alzheimer’s diagnosis is deeply challenging. The disease progresses until individuals can no longer care for themselves, and Black families bear a disproportionate burden because of persistent socioeconomic and environmental inequities linked to racism. Next, we will examine medications, other treatment options, and resources for individuals and families living with Alzheimer’s. It truly takes a village.