Dementias become more prevalent with increasing age. As the growth in the geriatric population increases, so does their incidence. Risk factor profiling, neuroimaging, and neurocognitive testing are helping provide objective evidence for determining between normal aging and cognitive deficit states. The diagnosis usually can be made, however, by a careful interview of the patient and a reliable informant and a detailed physical examination with emphasis on the neurologic and mental status examinations, followed by standard laboratory testing. Earlier therapeutic intervention can make a long-term difference in outcome. Distinguishing variants of dementias grants the clinician an opportunity of intervening based on etiology and similarities in neurotransmitter deficit states. Palliative ways of slowing progressive decline are available primarily by way of ChEIs, although no cures yet exist for the dementias. Optimizing current treatments makes sense in improving the quality of life of sufferers.