OBJECTIVES: Over the past 20 years, there have been research efforts, global initiatives, and new therapies aimed at awareness, diagnosis, and care of individuals with Alzheimer’s disease (AD).  The OptumLabs^TM Data Warehouse (OLDW), a large database including administrative claims data on privately insured and Medicare Advantage enrollees, was used to investigate 20-year trends in AD diagnoses and AD-specific drug prescribing. METHODS: Demographics and prevalence of AD, as well as prescription counts for the treatment of AD were evaluated among individuals enrolled each year from 1996 to 2014. Prescription counts for the treatment of AD were identified as the number of individuals with at least one 30-day fill for a medication used to treat AD per year during the study period. New cases of AD were identified if they received a second AD diagnosis and/or were prescribed an AD-specific medication within six months of initial diagnosis.  Additionally, individuals with major psychoses prior to AD diagnosis were excluded.  Time trends were examined. RESULTS: Prevalence of AD grew from 4 per 10,000 to 70 per 10,000 lives over time with the largest increase between 2005 and 2010. The majority of AD cases were female, Caucasian, and over 65 years of age at diagnosis. On average, 3,522 new cases of AD were diagnosed annually.  Donezipil has been the most commonly prescribed treatment for AD since its approval in 1997 followed by namenda, which was approved in 2003. In 2014, 51% and 30% of individuals with AD had at least one 30-day prescription for donezipil and namenda, respectively. CONCLUSIONS: Increased awareness, improved guidelines for diagnosis and more treatment options have contributed to a 23 fold-increase in AD diagnoses and subsequent increase in treatment over the last two decades.