Just because air density decreases does not mean you automatically need a higher pitch attitude. If you are flying at 1000' MSL at 100 KIAS you will have the same pitch attitude as you would flying 100 KIAS at 10,000' MSL. The only difference is that at 1000' your true airspeed will be around 102 and at 10,000' it will be about 120.
The same goes for stall speed, if your airplane stalls at 44 KIAS at sea level, then it will stall at 44 KIAS at 10,000' MSL. The only difference the extra altitude makes is that your TAS will be about 20% faster when you stall. IAS will not change.
The reason IAS does not change is because it measures dynamic pressure, in simplest terms the amount of air molecules flowing over the wing at any given time. Since the air is 'thinner' at higher altitudes, you have to go faster (TAS) to get the same amount of air flow.
You can use this to your advantage. Airspeed is also proportional to your drag. The higher your IAS, the more drag is created. The rule of thumb is that drag increases with the square of your speed. You want to go twice as fast, better bring 4x the power! The Cirrus SR20 and 22 are a perfect example. Even with 110 more horsepower, the SR22 only goes about 20 KTAS faster than the SR20. Sure climbs better though.
Since you can't really get more power, you can climb higher into thinner air. It seems 75% power is usually used for max cruise power in piston airplanes. If your airplane cruises at 110 KIAS at 1000' MSL your TAS will be around 112. Climb to 7-8,000' (the highest altitude you can maintain 75% in a normally aspirated airplane) and you can cruise at the same 110 KIAS, but now your TAS is around 126. So for the same fuel burn and power setting, you can pick up 14 kts, give or take a few.
This is really apparent in the jets, if you are cruising in the high 30's, if the IAS is around 220 the TAS will be around 440.