The 60-year-old writer invited television cameras to follow the "dark path" of his condition over the course of a year for a BBC Two documentary.
Viewers will see him struggling to write his Discworld books and trying out experimental "cures" as he attempts to stave off the symptoms of the degenerative brain disease.
Pratchett was diagnosed with early onset Alzheimer's in December 2007 and donated $1 million to fund research into the condition.
In the two-part documentary, Terry Pratchett: Living With Alzheimer's, the author says: "I've decided I'm not going to go down without a fight. For me, this really is a matter of life and death. This damn disease is not going to go away, it's only going to get worse. There is a war being fought out there and maybe it's time to go and join the troops."
He suffers from posterial cortical atrophy (PCA), a rare form of the disease which affects the part of the brain that deals with vision. He has difficulty with spelling and reading, and it takes him several minutes to perform simple functions such as knotting a tie.
In one uncomfortable scene, Pratchett is forced to halt a book reading when he loses the ability to read the words on the page. He acknowledges: "What may look like a nightmare from the outside is just one day at a time for me."
Among the unproven treatments he tests out is a bizarre-looking helmet invented by a GP, Dr Gordon Dougal, who claims it can halt degeneration by firing infrared light at brain cells. Pratchett admits: "Like anyone who suffers from an incurable disease, I will grab hold of even the slightest promise of hope. There is a kind of empowerment in knowing that you are doing something."
Throughout all, Pratchett maintains his black humour and is determined not to be seen as a victim. "I don't particularly want to be 'Terry Pratchett, the famous Alzheimer's sufferer'. Everywhere I go, people expect me to be some kind of a wreck and it's beginning to get on my nerves."
Just watched the first episode.
It's very well-made, Terry is as alway very endearing, funny and honest.
The programme itself scared the **** out of me. I don't want that to happen to me, or to any of my loved ones.