Do You Still Need Preventive Healthcare When Living With Early-Stage Alzheimer’s?

When you’re diagnosed with early-stage Alzheimer’s disease, it’s understandable if memory care becomes your primary health concern. But keeping regular appointments with your neurologist doesn’t mean you stop needing preventive healthcare.

Alzheimer’s care is part of medical care, not a replacement for it, says Nathaniel A. Chin, MD, associate professor in the department of medicine at the University of Wisconsin and medical director and clinical core co-leader of the Wisconsin Alzheimer’s Disease Research Center in Madison.

“In fact, preventive care often becomes even more important, because the goal is not only to treat memory symptoms, but also to preserve day-to-day function, reduce avoidable complications, and help the person remain as independent and engaged as possible,” says Dr. Chin.

What Is Preventive Care?

Preventive care is the routine care you receive to help prevent illness, find problems early, and lower the risk that a manageable issue becomes a crisis.

It can include:

• Vaccines to help prevent serious infections
• Screening for conditions such as high blood pressure, diabetes, high cholesterol, osteoporosis, depression, anxiety, hearing loss, vision loss, and some cancers
• Medication reviews to look for side effects, interactions, or drugs that may increase confusion, dizziness, or falls
• Fall-risk checks and home-safety guidance
• Lifestyle support around exercise, nutrition, sleep, alcohol use, smoking, and social connection
• Planning conversations about safety, future care, and who should help make decisions if memory symptoms progress

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Preventive Care That Should Continue After an Alzheimer’s Diagnosis

Early-stage Alzheimer’s is a time to plan, not to give up, says Chin.

“The diagnosis gives us a new lens through which to view the person’s overall health. We still care about blood pressure, diabetes, cholesterol, vaccines, cancer prevention, dental care, and vision and hearing, but we may change how we prioritize them,” he says.

Chin says the “million-dollar question” to consider when deciding what preventive care should continue is will this care help the person feel better, function better, avoid hospitalization, remain safe, or maintain independence?

Several kinds of preventive care remain especially important because they can affect day-to-day function, says Chin. They include:

Heart and Metabolic Care Managing blood pressure, diabetes, cholesterol, heart disease, and other metabolic health issues can help reduce the risk of stroke, heart attack, kidney problems, and other complications that may worsen function or lead to hospitalization.

Vaccines Staying up to date on recommended vaccines — including flu, COVID-19, pneumococcal, shingles, RSV when appropriate, and tetanus boosters — can help prevent infections that may trigger delirium, weakness, hospitalization, or a sudden loss of independence.

Vision and Hearing Care Hearing and vision loss can make it harder to communicate, follow conversations, stay socially connected, and safely move through daily life. Sensory loss can also make cognitive symptoms seem worse, says Chin.

Dental Care Dental pain, infection, trouble chewing, and poor nutrition can affect mood, behavior, comfort, and quality of life. Regular dental care can also help prevent problems that may become harder to treat as Alzheimer’s progresses.

Fall Prevention This can include checking for dizziness or low blood pressure, assessing gait and balance, encouraging safe strength and balance exercises, and making the home safer.

Mental Health and Sleep Care Depression, anxiety, poor sleep, and sleep apnea symptoms can all affect thinking, mood, and daily function. Chin says mental health remains a priority because it is central to quality of life and may contribute to cognitive and functional decline.

Some safety conversations may not sound like traditional preventive care, but they can be among the most important, says Chin. These include conversations about driving, medications with potentially problematic side effects, cooking safety, financial safety, firearms if present, home safety, and caregiver stress.

“These are not always thought of as ‘preventive care,’ but they are among the most important ways we prevent crises,” he says.

Types of Screening or Care That Might Be Stopped After an Alzheimer’s Diagnosis

Other interventions may become less useful as a person ages or dementia progresses. Chin says your doctor will likely discuss two key questions with you when deciding whether it makes sense to stop certain types of care:

• Is the medical event you are screening for or preventing likely to occur during your lifetime?
• Does the testing, follow-up, sedation, treatment, anxiety, or logistical burden outweigh the likely benefit?

“This is consistent with how we already think about preventive care in older adults,” Chin says. Alzheimer’s disease should not lead to a reflexive stopping of care, but it should prompt a more thoughtful conversation about which preventive measures still serve the person’s health, independence, and goals, says Chin.

Cancer screening is one area in which this often comes up. Tests such as colonoscopy, mammogram, prostate cancer screening, or lung cancer screening may still make sense for some people with early-stage Alzheimer’s, especially if they are otherwise healthy, independent, and likely to benefit from early detection, says Chin.

“I frequently recommend stopping most cancer screening in the moderate stage of dementia because life expectancy is lower and there are more pressing issues such as living environment — staying home versus going to a facility — and addressing behavioral and psychological symptoms of dementia, such as hallucinations, paranoia, and agitation,” says Chin. The goal is not to deny care, but to avoid tests that are unlikely to benefit the person and may cause harm, he adds.

The same thinking can apply to treatment goals for blood pressure, blood sugar, cholesterol, and other chronic conditions. In early-stage Alzheimer’s, treatment often continues, especially when it helps prevent stroke, heart attack, kidney disease, or symptoms. But goals may need to be adjusted if treatment is causing dizziness, falls, weight loss, medication confusion, low blood sugar, swallowing trouble, or a high pill burden, says Chin.

Very tight diabetes control, for example, can raise the risk of hypoglycemia, or low blood sugar, which can lead to confusion, falls, or hospitalization. “Blood pressure treatment may also need to be adjusted if it causes lightheadedness or falls,” he says.

As Alzheimer’s progresses, the balance may shift again. “A plan that makes sense in the mild stage may need to be revisited in the moderate stage, after a move to a care facility, or when a person needs more help with dressing, bathing, eating, or toileting,” says Chin.

The Value of Shared Decision-Making

Shared decision-making is how you and your healthcare team turn those lists into a plan that fits your health, stage of Alzheimer’s, support system, and goals.

Chin recommends using medical visits to ask practical questions about each screening, vaccine, medication goal, or preventive step:

• What benefit are we hoping for from this care?
• Is that benefit likely to matter in the next few years?
• What are the burdens to consider for each screening, such as preparation, transportation, sedation, anxiety, follow-up tests, or treatment decisions?
• If a screening test finds something, what would the next step be? And would that next step fit what I want?
• Are any medications or treatment targets increasing my risk of dizziness, falls, confusion, low blood sugar, or hospitalization?

Bringing a trusted family member or care partner to appointments can help with notes and follow-up, but the person living with Alzheimer’s should have a voice in what feels worth it, what feels too burdensome, and what trade-offs they are willing to accept.

Advance directives or healthcare power of attorney may fit into this discussion if they help clarify who should speak for you later and what kind of care you would want. But the immediate goal is simpler: to make sure today’s preventive care supports the life and health priorities that matter most to you now.

The bottom line: Early-stage Alzheimer’s is a time to plan, not to give up, says Chin. “The best preventive care helps the person live as well as possible for as long as possible,” he says.