Alzheimer disease (AD) and related dementias are major social problems threatening the lives of individuals and families and the viability of health care systems around the world. Advances in biological research are beginning to pay off with both short-term and long-term strategies for the development of more effective medications. Short-term strategies are aimed at treating the primary cognitive symptoms in AD as well as the secondary behavioral disturbances that occur frequently. Short-term strategies include drugs that act on cholinergic systems, including muscarinic agonists and cholinesterase inhibitors, to improve memory and perhaps attention. Drugs that act through bioaminergic systems may be useful in treating the behavioral symptoms. Long-term strategies for drug development are focusing on medications that may slow the progression of the disease. Growth factors and drugs that may act through other mechanisms to prevent alterations in cell metabolism offer the hope of actually preventing neural degeneration.