Treatment has three strands: medications that modestly support cognition, newer anti-amyloid therapies for selected people in early disease, and management of the symptoms and practical consequences, which is where most of the day-to-day benefit actually comes from. Most day-to-day benefit comes from the third strand rather than the medications.
Treatment has three strands: medications that modestly support cognition, newer anti-amyloid therapies for selected people in early disease, and management of the symptoms and practical consequences, which is where most of the day-to-day benefit actually comes from. Most day-to-day benefit comes from the third strand rather than the medications.
Cholinesterase inhibitors are used across mild to moderate disease and memantine is added in moderate to severe disease, sometimes together. Expect modest benefit rather than reversal: they can improve or stabilise cognition and function for a period, and some families notice the difference most clearly if the drug is stopped. Side effects are usually gastrointestinal and often settle, and doses are increased gradually for that reason. They do not alter the underlying disease process.
Anti-amyloid antibody treatments target the disease biology rather than the symptoms, and represent a genuine change in approach. The constraints matter as much as the promise: they are for early Alzheimer's disease with confirmed amyloid, they require regular intravenous infusion and periodic MRI monitoring for brain swelling and small bleeds, and eligibility is narrow. This practice operates no infusion suite and no imaging suite, so infusions and monitoring scans are arranged elsewhere while neurological care continues here.
Managing symptoms and consequences generally produces more day-to-day benefit than the cognitive medications do. That means treating sleep problems, low mood and anxiety, reviewing every medication for anticholinergic burden, correcting hearing and vision, and putting structure and safety measures in place. Non-drug approaches come first for agitation. Where antipsychotics are considered, the risks are real and the diagnosis matters, since Lewy body dementia carries severe sensitivity to them.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: Alzheimer disease; National Institute on Aging; American Academy of Neurology.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.