Alzheimer's disease (AD) is the main cause of progressive decline during which there is progressive dependence on family members and the health care system. The first step in the treatment is to make a diagnosis and communicate it to patients and families. The many things that should be done for optimal management must be started early. In the majority of patients enhancement of cholinergic function can produce a plateau for a period of time or at least can reduce the speed of decline. Comprehensive and appropriate treatment plans that meet all patients' needs can only be developed as a result of thorough assessment of the patient, the family, and the home environment. The assessment should address the patient's medical condition, including functional status, cognitive status, other medical conditions and non cognitive symptoms of AD. The assessment should also address the caregiver's needs and risks. Physicians should solicit and consider their input in post-diagnostic treatment planning. Comprehensive reassessment should occur every 6 months or more frequently with any sudden decline or be havioral change. The primary care practitioner should provide information and education about current level of disease and should talk with the patient and family to establish treatment goals.