After an Alzheimer's diagnosis it's not to late to get your finances in order

By Jessica Hall

Getting diagnosed with dementia isn't the end. It's a time to take financial action.

About 7.4 million Americans age 65 and older are currently living with Alzheimer's, according to the Alzheimer's Association.

A dementia diagnosis isn't a time to give up. It's a call for action.

"Prepare, prepare, prepare. Your wills. Your investments. Your caregiving. Your living situation. And communicate," said Zaldy Tan, author of the new book "What to Remember When You Are Forgetting: How to Live and Thrive With Memory Loss, Alzheimer's, and Other Dementias."

Careful planning in the early stages of memory loss can prevent financial and estate-planning headaches later. It could also avoid burdening your caregivers who may not know your wishes for how you want to live and die, said Tan, who is also the director of the memory and healthy aging program at Cedars-Sinai Medical Center in Los Angeles and a professor at UCLA's school of medicine.

"Nobody should be doing this alone. You really can't. You will lose, at some point, the ability to do it on your own so why not bring in someone early in the process? Why not start having a conversation with someone you trust about what you want to do, what you want to have done?" Tan told MarketWatch.

The lifetime risk of dementia after age 55 is about 42%, according to a 2025 study published in the journal Nature Medicine. Around 1 million adults in the U.S. are projected to develop dementia each year by 2060, compared with around 514,000 in 2020, the study found.

An estimated 7.4 million Americans age 65 and older are currently living with Alzheimer's, according to the Alzheimer's Association. The percentage of people with Alzheimer's increases with age: 5.2% of people ages 65 to 74 have the disease, while 35.8% of those ages 85 and older do.

"It's definitely going to be a bigger burden, especially if we don't find a way to slow it or even stop it. There are trials going on right now to do just that but it's too early to tell if they'll be effective or not. It's going to go from about 7 million people today to double or triple in 20, 30 years," Tan said.

Lifestyle factors - such as diet, sleep, regular exercise, managing blood pressure and blood sugar, avoiding tobacco and alcohol - can reduce the risk of dementia by up to 45%, Tan said. Issues such as having a parent or sibling with dementia, as well as traumatic brain injury, increase your overall dementia risk, however.

"You can't change your genes and you can't change your parents and you can't bring back the sands of time, but at least you can look forward and say what are the risk factors that are modifiable that you can do - and the earlier, the better," Tan said.

Do a will and estate planning

In the early stages of dementia, addressing your estate plans as soon as possible is important. Create a will, and select your financial and medical powers of attorney.

"Of course it would have been better if they had done a will before a diagnosis, but still - early Alzheimer's disease is the time to do it. You have a window of about three years or so when you can still make complex decisions," Tan said.

If the disease has progressed to the moderate stages, Tan suggested getting a capacity evaluation by a neuropsychologist or a psychologist trained in testing to determine whether or not you have the ability to make estate decisions and sign a will.

"It will cost some money, but it is far worth investing in," Tan said.

People with dementia and Alzheimer's diagnoses and their caregivers also must weigh other big milestones such as stopping driving, quitting a job or handing over management of household finances, Tan said.

Driving is one task that becomes a safety issue - and in some states, a legal issue. In California, for example, doctors are required to make a mandatory medical report to the state Department of Motor Vehicles for those with a dementia diagnosis. Other issues, such as working, depend on the individual, their abilities and their wishes, Tan said.

"You don't have to completely stop working because you have dementia, especially in the early stage. A lot of jobs can be reconfigured so they are still doable, you're still safe and you're still contributing. It requires creativity and flexibility," Tan said. "Volunteering is also a wonderful thing."

Hope for the future

Tan said he sees progress and hope among the research and ongoing drug development for Alzheimer's.

"For diseases like ALS, multiple sclerosis, Parkinson's, stroke - there is no cure for neurological diseases. For Alzheimer's - we know more about prevention and risk-reduction than we do about these other neurological diseases, which come out of the blue," Tan said.

"There are a lot of new medications in the pipeline to slow it down. To cure it, no. The hope is we can slow it enough that it's not going to affect their overall life expectancy and their quality of life if we can maintain function as long as possible," Tan said.

With a diagnosis comes some urgency to travel, learn and live as long as possible, he said.

"Prepare. Be proactive. Life is meant to be lived. Try to squeeze in as much as you want to do very early on. And in the future, have the plan in place so you can remain functional as long as possible," Tan said.

-Jessica Hall

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