WASHINGTON -- Elaine Vlieger is making some concessions to Alzheimer's. She's cut back on her driving, frozen dinners replace elaborate cooking, and a son monitors her finances. But the Colorado woman lives alone and isn't ready to give up her house or her independence.

Some 800,000 people with Alzheimer's, roughly 1 in 7 Americans with the disease, live alone, according to data from the Alzheimer's Association. It's a different picture from the constant caregiving that they'll eventually need.

Many such as Vlieger cope on their own during dementia's earlier stages with support from family and friends who keep in close contact. "I'm still pretty healthy," says Vlieger, 79, who sought a neurology exam after realizing she was struggling to find words. "I'm just real careful."

But with support or not, living alone with a disease that gradually strips people of the ability to know when they need help brings concerns, and loved ones on the sideline agonize over when to step in. "We don't want to have to force it before it's time. But how do we know?" asks Marla Vlieger of Denver, Elaine Vlieger's daughter-in-law.

There's no easy answer, and it's a challenge that will only grow. About 5.4 million people in the United States have Alzheimer's or similar dementias. That number is expected to reach up to 16 million by 2050 with the population aging so rapidly.

Most older people want to stay in their homes as long as possible, and developing cognitive impairment doesn't automatically mean they can't, says Beth Kallmyer of the Alzheimer's Association. The association's new analysis illustrates the balancing act between a patient's autonomy and safety. People with dementia who live alone tend to be less impaired than those who live with caregivers. But studies show they have a greater risk of injuries or accidental death than those who don't live alone.

The first National Alzheimer's Plan, due this month, may help. It aims to increase screening to catch dementia earlier and urges doctors to help plan for care.

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