Disease-modifying therapies promise to become available as understanding of the pathophysiological basis of Alzheimer's disease (AD) improves. The emergence of disease-modifying therapies requires reconsideration of the role of symptomatic agents in the management of AD. Combination therapy with disease-modifying and symptomatic agents will be optimal therapy for patients who have progressed to diagnosable AD. Symptomatic agents also may have a role in delaying the progression to AD in patients with mild cognitive impairment. In addition to current symptomatic treatment with cholinesterase inhibitors and memantine, other symptomatic approaches to the treatment of AD are under study. Therapeutic regimens for the treatment of AD will include both disease-modifying and symptomatic agents.