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Health condition · Clinically reviewed

Dementia, diagnosis, care and where anti-amyloid therapy sits today.

Not one disease but several. A structured plan from GP to memory clinic makes a real difference to the person living with dementia and the family around them.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE NG97, the Lancet Commission 2024 and MHRA guidance you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK dementia care, including the lecanemab and donanemab landscape and the latest NICE positions.

Key facts

Dementia at a glance.

The essentials, in plain English - what it is, the main types and how it is assessed and managed in the UK.

  • What it is

    A progressive syndrome of cognitive decline severe enough to interfere with daily activities, caused by several different diseases of the brain.

  • How common

    Around 944,000 people in the UK were living with dementia in 2024, and the number is rising as the population ages.

  • Commonest type

    Alzheimer's disease accounts for roughly 60 to 70 per cent of cases, followed by vascular, Lewy body and frontotemporal dementias.

  • Mixed pathology

    Mixed Alzheimer and vascular disease is common in older adults and is often missed on a single scan.

  • Reversible causes

    A small proportion of cognitive decline is caused by treatable problems, such as B12 deficiency, thyroid disease or depression.

  • Where care starts

    The GP arranges initial screening and bloods and refers to a specialist memory clinic for diagnosis and support.

Why this guide matters

Several diseases, one careful plan.

Alzheimer\'s, vascular, Lewy body and frontotemporal dementia all sit under the same umbrella but behave differently. Getting the subtype right shapes everything that follows.

  • Not one disease

    Alzheimer's (60 to 70 per cent), vascular (15 to 20 per cent), Lewy body (10 to 15 per cent), frontotemporal (around 5 per cent) and often mixed pathology.

  • Some causes are reversible

    B12 deficiency, hypothyroidism, depression, medications, subdural haematoma and normal pressure hydrocephalus can all mimic dementia and deserve a full workup.

  • Care is a team sport

    GP, memory clinic, specialist nurses, therapists, social care and family. Non-pharmacological care and vascular risk reduction do most of the heavy lifting.

How the diagnosis is made

From first concern to a written care plan.

The steps NICE NG97 expects a UK GP and memory clinic to work through, in order - so families know what to expect and why.

  1. 01

    Assessing

    History and collateral

    A structured account from the patient and, crucially, a family member or carer, covering timeline, medications, medical and family history.

  2. 02

    Assessing

    Cognitive screening

    Bedside tests such as GPCOG, MMSE, MoCA or ACE-III to map memory, language, executive function and visuospatial skills.

  3. 03

    Assessing

    Routine bloods

    FBC, U&Es, LFTs, calcium, glucose, TFTs, B12, folate and HbA1c to look for reversible or contributing causes.

  4. 04

    Confirming

    MRI or CT brain

    Structural imaging to look at atrophy pattern, hippocampal volume, vascular changes, white matter hyperintensities and microbleeds.

  5. 05

    Confirming

    Specialist memory clinic

    Referral for a full multidisciplinary assessment in a dementia-friendly setting, with feedback and follow-up.

  6. 06

    Planning

    Selective advanced tests

    FDG-PET, DaT-SPECT, CSF amyloid and tau, EEG or genetic testing where the clinical picture calls for them.

  7. 07

    Planning

    Diagnosis and planning

    Diagnostic disclosure, advance care planning, Lasting Power of Attorney, driving and financial advice, and a written care plan.

Typical timeline: GP assessment to memory clinic diagnosis in weeks to a few months, depending on local waits.

Types

The main subtypes, and why the label matters.

Getting the subtype right changes which drugs help, which drugs to avoid and what to expect over time.

  • Alzheimer's disease (60 to 70 per cent)

    Insidious onset, episodic memory loss, language and visuospatial change. Underlying amyloid and tau pathology.

  • Vascular dementia (15 to 20 per cent)

    Stepwise decline, vascular risk factors, subcortical or multi-infarct patterns on imaging.

  • Lewy body dementia (10 to 15 per cent)

    Fluctuating cognition, visual hallucinations, parkinsonism, REM sleep behaviour disorder and neuroleptic hypersensitivity - avoid antipsychotics.

  • Frontotemporal dementia (around 5 per cent)

    Younger onset. Behavioural variant with disinhibition and apathy, or primary progressive aphasia.

  • Mixed dementia (10 to 30 per cent)

    Alzheimer's and vascular pathology together is very common in older adults and often underestimated.

  • Parkinson's disease dementia

    Dementia arising more than a year after motor Parkinson's. Shares many features with Lewy body dementia.

  • Rarer causes

    CJD, Huntington's, HIV, alcohol-related brain damage, chronic traumatic encephalopathy, corticobasal degeneration, progressive supranuclear palsy, normal pressure hydrocephalus and autoimmune encephalitis.

  • Reversible mimics

    Vitamin B12 deficiency, hypothyroidism, depression, medications, subdural haematoma and NPH can all masquerade as dementia and deserve treatment in their own right.

Symptoms

What dementia actually looks like.

The classic mix of cognitive, functional and behavioural change - and the features that mean it is time to seek urgent help.

  • Memory loss

    Difficulty remembering recent conversations, appointments or events, often noticed by family before the person themselves.

  • Language difficulty

    Word-finding trouble, repeating questions, or losing the thread of a conversation.

  • Executive and planning problems

    Trouble managing finances, cooking, driving or following multi-step tasks.

  • Visuospatial and praxis change

    Getting lost in familiar places, misjudging distances, or struggling to dress or use utensils.

  • Behavioural and psychological symptoms

    Agitation, aggression, wandering, hallucinations, delusions, apathy, low mood, sleep and appetite change.

  • Fluctuating cognition

    Marked day-to-day or hour-to-hour variation is a classic feature of Lewy body dementia.

  • Personality or behaviour change

    Early disinhibition, apathy or loss of empathy points towards behavioural-variant frontotemporal dementia.

  • Red flag - rapid decline

    Fast progression over weeks or months, myoclonus or focal signs need urgent neurology review to exclude rarer causes.

Treatment

How dementia is managed in the UK.

Cognitive stimulation, cholinesterase inhibitors and memantine, vascular risk reduction and careful management of behavioural symptoms - with anti-amyloid therapy an emerging private option.

  • Cholinesterase inhibitors

    Donepezil, rivastigmine or galantamine for mild to moderate Alzheimer's disease, and for dementia with Lewy bodies and Parkinson's disease dementia.

  • Memantine

    An NMDA antagonist used for moderate to severe Alzheimer's disease, or when cholinesterase inhibitors are not tolerated.

  • Anti-amyloid therapy

    Lecanemab and donanemab are MHRA approved but currently not funded on the NHS. Available privately at specialist centres with strict criteria and MRI monitoring.

  • Cognitive stimulation therapy

    Structured group CST, reality orientation, reminiscence and music-based interventions have the best evidence for non-pharmacological benefit.

  • BPSD - non-drug first

    Identify triggers, treat pain, review medication, exclude delirium and UTI, and use environment, activity, music and Snoezelen approaches.

  • BPSD - selective medication

    Short-course risperidone only for severe risk, with MHRA warnings on stroke and mortality. SSRIs, trazodone or memantine adjuncts where appropriate.

  • Vascular risk management

    Blood pressure, lipids, diabetes, smoking and atrial fibrillation control to slow vascular contribution to decline.

  • MDT and community support

    GP, memory clinic, old-age psychiatry, neurology, Admiral Nurses, OT, physio, speech and language, dietitian and social work working together.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and major international evidence, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or specialist knows the person and their history and can tell you which parts apply. If in doubt, ask for a memory clinic referral.

  • NICE. Dementia: assessment, management and support for people living with dementia and their carers (NG97).

  • Lancet Commission on dementia prevention, intervention and care - 2024 update (14 modifiable risk factors).

  • MHRA. Antipsychotics in dementia - stroke and mortality warnings; approval notices for lecanemab and donanemab.

  • Alzheimer's Society and Dementia UK - patient and carer guidance and Admiral Nurse standards.

Red flags

When dementia care needs urgent action.

Most dementia care is planned and unhurried. These are the situations that are not - and where GP, memory clinic or emergency review is needed.

  • Rapidly progressive cognitive decline

    Deterioration over weeks or a few months needs urgent neurology review to exclude CJD, autoimmune encephalitis and other rare causes.

  • Focal neurological signs

    New weakness, sensory loss, visual field defect or seizures suggest a structural or vascular cause and need urgent imaging.

  • Delirium superimposed on dementia

    Sudden fluctuating confusion in a person with dementia is delirium until proven otherwise - look for infection, pain and medication changes.

  • Neuroleptic hypersensitivity in DLB

    Antipsychotics can cause severe rigidity, drowsiness and worsening confusion in Lewy body dementia. Avoid where possible.

  • Falls and syncope

    Recurrent falls, especially in DLB or Parkinson's disease dementia, need medication review, gait assessment and cardiovascular workup.

  • Suicidal ideation or severe depression

    Common at diagnosis and during decline - needs urgent mental health assessment and support for the person and their family.

  • Safeguarding concerns

    Self-neglect, financial abuse or unsafe home environment need a social care referral and, where needed, a safeguarding alert.

  • Driving risk

    A dementia diagnosis must be notified to the DVLA. Continued unsafe driving needs a clear, documented conversation and, sometimes, a formal assessment.

  • Signs of NPH

    The triad of gait apraxia, cognitive decline and urinary incontinence should prompt consideration of normal pressure hydrocephalus and neurosurgical review.

Living with it

A long condition, with real levers.

Four things that make the biggest difference for the person and their family - planning early, reducing modifiable risk, using specialist support and looking after the carer.

A quiet reminder

Small, kind, consistent care wins.

Routine, familiar people, calm environments and treating pain, infection and low mood do more, day to day, than any single tablet.

  1. 01 Plan

    Get the paperwork in early

    Lasting Power of Attorney for health and finance, an up-to-date will and a written advance care plan are much easier to do soon after diagnosis than later.

  2. 02 Reduce

    Work on modifiable risk

    The Lancet Commission highlights hearing, blood pressure, physical activity, smoking, alcohol, air quality, vision and social contact as levers you can actually pull.

  3. 03 Support

    Bring in the specialists

    Admiral Nurses, memory clinics, Alzheimer's Society and Dementia UK exist to walk families through this - use them from the start, not the crisis.

  4. 04 Carers

    Look after the carer

    A carer's assessment, respite, day care and benefits like Carer's Allowance and Attendance Allowance are part of the plan, not optional extras.

Frequently asked

Everything we get asked about dementia.

Quick answers on subtypes, memory clinics, medication and where anti-amyloid therapy fits.

  • What is dementia?

    Dementia is a progressive syndrome of cognitive decline severe enough to interfere with daily activities. It is caused by several different diseases of the brain, most commonly Alzheimer's disease, vascular disease, Lewy body pathology and frontotemporal degeneration.

  • How common is dementia in the UK?

    Around 944,000 people were living with dementia in the UK in 2024, and numbers are rising with the ageing population. Prevalence roughly doubles every five years after the age of 65.

  • Are lecanemab and donanemab available on the NHS?

    Both are MHRA approved for early symptomatic Alzheimer's disease with confirmed amyloid, but NICE has not recommended them for NHS funding on cost and safety grounds. They are available privately at specialist centres with strict criteria, APOE genotyping and MRI monitoring for ARIA. See our lecanemab and donanemab clinic page for the current position.

  • What does a memory clinic actually do?

    A memory clinic brings together old-age psychiatrists, neurologists, specialist nurses and psychologists to make a formal diagnosis, plan treatment, coordinate MDT support and follow patients and families over time.

  • Which cognitive symptoms are most concerning?

    Progressive short-term memory loss, executive and planning problems, visuospatial change, language decline and behavioural change are all worth investigating. Rapid decline over weeks, focal neurological signs, myoclonus or fluctuating conscious level need urgent assessment.

  • What can families and carers do?

    Ask for a carer's assessment, use Admiral Nurses and Alzheimer's Society support, get Lasting Power of Attorney in place early, treat vascular risk factors and, where possible, keep the person cognitively, physically and socially active. Non-pharmacological approaches are the first line for behavioural symptoms.

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