Although the cause of Alzheimer disease (AD) remains a mystery, a great deal of progress has been made over the past 15 years. A large body of evidence suggests that beta amyloid (Abeta) deposition and toxicity are critical steps leading to neuronal death in AD. Evidence is beginning to show that antioxidant and antiinflammatory drugs and estrogen may prevent, delay onset, or slow the progression of AD. Until a cure is found it will be necessary to provide high-quality long-term and palliative care in the community or in specialized treatment centers. The AD patient's caregiver often suffers in silence and research is needed to better understand disease burden to design appropriate interventions for these victims of AD.