Alzheimer's disease (adjunct)
Also known as: Alzheimer's disease, Alzheimer disease, dementia due to Alzheimer's disease, major neurocognitive disorder due to Alzheimer's disease, mild cognitive impairment due to Alzheimer's disease, younger-onset Alzheimer's disease, early-onset Alzheimer's disease
Alzheimer's disease is a progressive neurodegenerative disease and the most common cause of dementia. It gradually affects memory, learning, language, orientation, judgement, behaviour and the ability to perform everyday activities. The underlying disease process is associated with abnormal accumulation of beta-amyloid plaques and tau-related neurofibrillary tangles, synaptic dysfunction, neuronal loss and progressive brain atrophy. Early symptoms commonly include difficulty retaining recent information, repeating questions, losing items, becoming disoriented, difficulty finding words and reduced ability to manage complex tasks. Progression may lead to impaired communication, behavioural and psychological symptoms, loss of independence, swallowing problems, reduced mobility and increased vulnerability to infection, falls and malnutrition. Diagnosis requires comprehensive medical assessment rather than a single test and may include history from the patient and a knowledgeable informant, cognitive and functional assessment, medication review, neurological examination, blood tests and brain imaging. Biomarker testing may be used in selected specialist settings. Management is individualised and may include cholinesterase inhibitors, memantine, treatment of contributing medical conditions, cognitive and functional support, exercise, hearing and vision care, advance-care planning, caregiver education and environmental adaptations. Anti-amyloid medicines may be considered for carefully selected people with early symptomatic Alzheimer's disease in jurisdictions where they are approved and available, but require specialist confirmation of amyloid pathology and monitoring for amyloid-related imaging abnormalities. TCM descriptions may overlap with Marrow Sea deficiency, Kidney essence deficiency, Spleen Qi deficiency with Phlegm, Phlegm misting the mind, Blood stasis obstructing the collaterals, Heart-Spleen deficiency or Liver-Kidney Yin deficiency. Acupuncture and Chinese herbal medicine may be considered only as adjunctive supportive care for selected stable symptoms. They must not replace neurological assessment, prescribed dementia medicines, management of delirium, stroke or infection, medication monitoring, safeguarding, caregiver support or advance-care planning. [1][2][3][4][5][6][7][8]
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Lifestyle & Diet
- •Arrange comprehensive medical assessment for persistent or progressive changes in memory, thinking, language, behaviour or daily function.
- •Take prescribed donepezil, rivastigmine, galantamine, memantine or other medicines exactly as directed.
- •Do not stop dementia medicines abruptly without consulting the prescriber.
- •Attend recommended reviews of cognition, function, adverse effects, heart rate, weight and medication burden.
- •Ask a pharmacist or doctor to review medicines with anticholinergic or sedating effects that may worsen cognition or falls.
- •Use regular physical activity suited to the person's mobility, cardiovascular health and interests.
- •Support social participation, meaningful activity and familiar hobbies without repeatedly testing or correcting the person's memory.
- •Maintain consistent daily routines and use clocks, calendars, labels, photographs and written prompts where helpful.
- •Address hearing loss and vision impairment with appropriate assessment and aids.
- •Support adequate hydration and a balanced diet.
- •Monitor weight, appetite, dental health and swallowing as the disease progresses.
- •Seek speech pathology assessment for coughing, choking, prolonged meals or recurrent chest infections.
- •Assess the home for fall, fire, cooking, medication, wandering and financial risks.
- •Use medication organisers, pharmacy-packed medicines or supervised administration when required.
- •Review driving safety early and comply with medical and licensing requirements.
- •Discuss enduring powers of attorney, advance-care planning, wills and future care preferences while the person can participate meaningfully.
- •Support the person's autonomy and preferences for as long as safely possible.
- •Avoid arguing about incorrect memories when reassurance, redirection or validation is safer and less distressing.
- •Investigate pain, constipation, urinary symptoms, infection, hunger, fatigue, loneliness and environmental stress when behaviour changes.
- •Use antipsychotic medicines only when clinically indicated, with informed discussion and regular review because they may cause serious adverse effects.
- •Avoid routine use of physical or chemical restraint.
- •Encourage vaccination and routine health care according to medical advice.
- •Manage blood pressure, diabetes, cholesterol, smoking, sleep and physical inactivity according to evidence-based care.
- •Provide carers with respite, education and support before exhaustion becomes a crisis.
- •In Australia, Dementia Australia and the National Dementia Helpline can provide information, advice and support.
- •Have an emergency plan for wandering, falls, missed medicines, acute illness and caregiver unavailability.
- •Use identification jewellery, location technology or home-security measures only with appropriate consent, privacy consideration and proportionality.
- •Do not use unregulated cognitive-enhancement supplements as substitutes for medical care.
- •Plan progressively for increased support with finances, cooking, medication, personal care, mobility and supervision.
Cautions & Contraindications
- •Do not claim acupuncture or Chinese herbal medicine cures Alzheimer's disease, removes amyloid plaques or reverses established neurodegeneration.
- •Do not delay assessment of cognitive decline because early diagnosis supports treatment, planning and identification of reversible contributors.
- •Do not treat sudden confusion as normal dementia progression.
- •Do not use acupuncture instead of emergency stroke, seizure, infection or delirium care.
- •Do not advise stopping cholinesterase inhibitors, memantine, anti-amyloid treatment, antidepressants, antipsychotics, cardiovascular medicines or anticoagulants without the prescriber.
- •Do not administer treatment without valid consent or lawful substitute consent.
- •Do not force, restrain or deceive a distressed person in order to needle them.
- •Do not leave an impaired person alone with needles in place.
- •Avoid oral herbs when swallowing is unsafe, consciousness is reduced or aspiration risk is high.
- •Avoid highly sedating herbal combinations in a person with falls, excessive sleepiness or concurrent sedative medicines.
- •Avoid strong purgative, diuretic or sweating-inducing formulas in frail, dehydrated or underweight patients.
- •Blood-moving herbs including Dān Shēn, Dāng Guī, Chuān Xiōng, Táo Rén, Hóng Huā and Niú Xī require anticoagulant, antiplatelet, falls and bleeding-risk review.
- •Gān Cǎo may cause sodium retention, hypertension, hypokalaemia and medicine interactions.
- •Bàn Xià and Tiān Nán Xī must be correctly processed because raw forms are toxic.
- •Yuǎn Zhì and Shí Chāng Pú require careful dosing and medicine-interaction review.
- •Hé Shǒu Wū has recognised hepatotoxicity risk.
- •Fù Zǐ must be correctly processed and professionally prescribed because of cardiotoxicity and neurotoxicity.
- •Mù Tōng must be botanically verified and free of aristolochic acid.
- •Avoid animal-derived or endangered-species ingredients that are unlawful, unethical or improperly sourced.
- •Screen all herbal prescriptions for liver or kidney disease, pregnancy, allergies, frailty and polypharmacy.
- •Do not use herbs as substitutes for treatment of depression, psychosis, severe agitation, sleep apnoea, infection or pain.
- •Do not use apparent short-term alertness as evidence that disease progression has stopped.
- •Do not encourage driving, unsupervised medication use, cooking or financial management when safety assessments indicate impairment.
- •Do not blame the person or caregiver for behavioural symptoms or disease progression.
When to reassess or seek care again
- •Review at 4-6 weeks after starting adjunctive TCM support to reassess tolerance, cognition, function, mood, sleep, falls, appetite and caregiver strain.
- •Reassess every 3 months alongside the medical dementia review, including cholinesterase-inhibitor or memantine effects, weight, heart rate and behavioural symptoms.
- •Reassess at least annually, or sooner with any functional change, to align with formal dementia staging and advance-care planning.
- •Sudden confusion, new agitation, fever, falls or functional decline — escalate for delirium and medical assessment before adjusting TCM care.
- •Post-stroke change, new neurological deficit or head injury — refer for medical reassessment.
- •New swallowing difficulty, aspiration or weight loss — request speech pathology review and reconsider oral herbs.
- •Caregiver crisis, safeguarding concern or unsafe driving — pause elective treatment and connect to appropriate services.
Apparent short-term improvement does not indicate disease modification. Any acute deterioration is medical until proven otherwise.
Frequently Asked Questions
What is Alzheimer's disease?+
Alzheimer's disease is a progressive brain disease and the most common cause of dementia. It gradually affects memory, thinking, communication, behaviour and everyday functioning [6].
Is dementia a normal part of ageing?+
No. Some minor changes in memory can occur with ageing, but dementia is caused by disease and is not an inevitable or normal part of getting older [6].
How is Alzheimer's disease diagnosed?+
Diagnosis requires a medical assessment that may include history from the patient and family, cognitive and functional testing, medication review, physical and neurological examination, blood tests and brain imaging. No single brief test diagnoses every case [6].
What symptoms require urgent assessment?+
Sudden confusion, abrupt weakness or speech change, fever, collapse, seizure, severe headache, reduced consciousness, rapid decline or new swallowing difficulty require urgent medical assessment [6].
Which medicines are commonly used?+
Cholinesterase inhibitors such as donepezil, rivastigmine and galantamine may be used for mild-to-moderate Alzheimer's disease. Memantine may be used in moderate or severe disease or when other medicines are unsuitable [6].
What are anti-amyloid medicines?+
Anti-amyloid monoclonal antibodies target amyloid in the brain and may modestly slow cognitive decline in carefully selected people with early symptomatic Alzheimer's disease. They require specialist testing, eligibility assessment and MRI monitoring and are not suitable for everyone [6].
What TCM patterns may be considered?+
Traditional patterns may include Kidney essence and Marrow Sea deficiency, Spleen Qi deficiency with Phlegm, Phlegm misting the Heart orifices, Blood stasis obstructing the brain collaterals, Heart-Spleen deficiency and Liver-Kidney Yin deficiency [9].
Can acupuncture cure Alzheimer's disease?+
No established evidence shows that acupuncture cures Alzheimer's disease or reverses neurodegeneration. It may only be considered as adjunctive support for selected stable symptoms [9].
Can Chinese herbs replace dementia medicines?+
No. Herbal medicines must not replace prescribed treatment and may interact with anticoagulants, cardiovascular medicines, sedatives and dementia medicines [9].
What is delirium?+
Delirium is a sudden change in attention, awareness or cognition caused by an acute medical problem. It develops over hours or days and requires prompt assessment [6].
How can caregivers be supported?+
Caregivers benefit from education, respite, practical planning, support groups, health care and clear emergency plans. In Australia, the National Dementia Helpline provides information and support [6].
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Sources & Further Reading
Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.
- Healthdirect Australia · 2026
Australian overview of symptoms, causes, diagnosis, treatment and living with Alzheimer's disease.
- Dementia Australia · 2025
Australian information explaining Alzheimer's disease, progression, diagnosis, management and support.
- Dementia Australia · 2026
Describes comprehensive assessment of cognitive, functional, behavioural, psychosocial, laboratory and imaging findings.
- Dementia Australia · 2026
Current Australian professional information on cholinesterase inhibitors, memantine and medicines used for selected behavioural symptoms.
- Dementia Australia · 2026
Current overview of dementia treatment, management and emerging amyloid-targeting therapies.
- National Institute for Health and Care Excellence · 2018
Evidence-based recommendations on diagnosis, cognitive medicines, behavioural symptoms, functional support, carer involvement and ongoing care.
- World Health Organization · 2026
Current international overview of dementia symptoms, causes, risk factors, care needs and public-health impact.
- Healthdirect Australia · 2025
Australian practical information about caregiver wellbeing, respite and support services.
- World Health Organization · 2008
Standardised acupuncture-point nomenclature and anatomical-location methodology.
- World Health Organization · 2020
International benchmarks for acupuncture education, competency and clinical safety.
Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.