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Health condition · Clinically reviewed

Dementia and Alzheimer’s, early signs, memory clinic and modern treatment.

Progressive cognitive impairment with many causes. Alzheimer’s is the most common; vascular, Lewy body and frontotemporal dementia are the others. Early diagnosis, symptom care and (now) disease-modifying therapy for select Alzheimer’s patients.

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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

    Every claim is checked against NICE, the Alzheimer’s Society and peer-reviewed sources you can see at the end.

  • 03

    Updated for 2026

    Reflects current UK guidance including the emerging role of anti-amyloid antibodies.

Key facts

Dementia at a glance.

The essentials, in plain English - what it is, what causes it, how it is diagnosed, and how it is treated in the UK today.

  • Definition

    Progressive cognitive impairment that interferes with daily function - memory, language, planning, behaviour or perception.

  • Most common cause

    Alzheimer’s disease accounts for roughly 60% of cases in later life.

  • Second most common

    Vascular dementia - caused by cerebrovascular disease - is the second most common cause.

  • Modifiable risk

    Modifiable risk factors matter - the Lancet Commission 2024 identifies up to 14 that can be addressed across life.

  • The pathway

    The memory clinic pathway is the standard NHS route for diagnosis and follow-up in the UK.

  • New treatment

    Anti-amyloid antibodies (lecanemab, donanemab) are emerging for select Alzheimer’s patients in early disease.

Why this guide matters

Early diagnosis changes everything.

Dementia care has moved on. The three points below shape the rest of this page.

  • Early matters more than ever

    Anti-amyloid antibodies only work in early Alzheimer’s - and support is far easier to arrange while capacity is preserved.

  • Risk factors are modifiable

    The Lancet Commission 2024 identifies 14 modifiable risk factors across life - many are addressable in mid-life.

  • The memory clinic is the door

    A multidisciplinary team is far better placed than a single appointment to get diagnosis, subtype and support right.

How the diagnosis is made

From first concern to a clear diagnosis.

The steps the memory clinic pathway normally follows, in order - so you know what to expect and why.

  1. 01

    Screening

    A cognitive screen

    A short, validated test - MoCA or ACE-III - measures memory, language, attention and executive function.

  2. 02

    Screening

    A comprehensive history

    From patient and an informant (partner, family) - what changed, when, and how it affects daily life.

  3. 03

    Screening

    Blood tests

    Rule out reversible causes - B12, folate, thyroid, calcium, glucose, liver and kidney function.

  4. 04

    Confirming

    Brain MRI

    Structural imaging looks for atrophy patterns, vascular disease, tumours and normal-pressure hydrocephalus.

  5. 05

    Confirming

    Formal neuropsychology

    If the picture is unclear - detailed testing separates dementia from depression, delirium and mild cognitive impairment.

  6. 06

    Confirming

    CSF or amyloid-PET

    Specialist biomarkers - lumbar puncture or PET imaging - confirm Alzheimer’s pathology in selected cases.

  7. 07

    MDT

    Memory clinic MDT diagnosis

    A multidisciplinary team makes the diagnosis, agrees the subtype and plans support, medication and follow-up.

Typical timeline: 3-6 months from first referral to a settled diagnosis and plan.

Symptoms

What dementia looks like in real life.

More than forgetting names. Different subtypes present differently - here is the shape of the early years.

  • Memory loss (episodic)

    Forgetting recent events, repeating questions, misplacing items - the classic early Alzheimer’s pattern.

  • Language and word-finding

    Pausing mid-sentence, substituting words, or difficulty following conversation.

  • Executive function decline

    Planning, sequencing, handling finances or cooking a familiar meal become harder.

  • Behavioural or personality change

    Apathy, disinhibition or irritability - especially prominent in frontotemporal dementia.

  • Visuospatial changes

    Judging distance, recognising faces or seeing detailed visual hallucinations - typical of Lewy body dementia.

  • Disorientation

    Getting lost in familiar places, or confusion about time and date.

  • Reduced daily function

    Trouble with shopping, medication, driving or personal care - the threshold that separates dementia from milder change.

  • Red flag: rapid decline

    Cognitive decline over weeks rather than months - urgent workup for autoimmune encephalitis, prion disease or delirium.

Treatment

How dementia is treated in the UK.

Medication for cognition, non-pharmacological care, vascular risk control and long-term planning - each with a role.

  • Cholinesterase inhibitors

    Donepezil, rivastigmine or galantamine - first-line for mild-to-moderate Alzheimer’s and Lewy body dementia.

  • Memantine

    For moderate-to-severe Alzheimer’s - alone or added to a cholinesterase inhibitor.

  • Anti-amyloid antibody

    Lecanemab and donanemab - specialist-only, for early Alzheimer’s with confirmed amyloid pathology.

  • BPSD medication

    Short courses only for behavioural and psychological symptoms - antipsychotics carry stroke risk in dementia.

  • Non-pharmacological care

    Cognitive stimulation therapy (CST) and tailored meaningful activities - proven benefit and no side effects.

  • Vascular risk factor control

    Blood pressure, cholesterol, diabetes, smoking - essential for vascular dementia and mixed disease.

  • Occupational therapy

    Home assessment, adaptations, cognitive strategies and support to maintain independence for longer.

  • End-of-life planning

    Advance care planning, lasting power of attorney and palliative-care conversations - best done early.

What this guide is based on

The sources behind every claim on this page.

UK national guidance, European specialist society standards and the most recent Lancet Commission - 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 memory clinic knows your history and can tell you which parts apply. If in doubt, seek assessment - especially with any red-flag features.

  • NICE. Dementia: assessment, management and support (NG97).

  • Alzheimer’s Society. Information and support resources.

  • European Academy of Neurology. Dementia guidelines.

  • The Lancet Commission on dementia prevention, intervention and care (2024).

Red flags

When cognitive change is not slow decline.

Most dementia progresses gradually. These are the patterns that need urgent assessment - do not wait.

  • Rapid cognitive decline

    Over weeks rather than months - urgent workup for autoimmune, prion, paraneoplastic or metabolic causes.

  • Delirium with fever

    Acute confusion with infection - treat the trigger and reassess cognition afterwards.

  • Focal neurology

    One-sided weakness, speech loss, visual field defect - urgent imaging to exclude stroke or space-occupying lesion.

  • Falls with head injury

    Anticoagulated patients especially - subdural haematoma can mimic worsening dementia.

  • Suicidal ideation

    Depression in early dementia is common and treatable - urgent mental-health assessment.

  • Severe BPSD

    Aggression, distress or psychosis endangering the person or carer - specialist review needed.

  • Antipsychotic-related stroke risk

    Any new antipsychotic in dementia raises stroke and death risk - reassess weekly.

  • Post-anaesthetic decline

    Sudden worsening after surgery - screen for delirium and medication side effects.

  • Palliative-stage crisis

    Poor oral intake, recurrent aspiration, pressure areas - trigger a palliative-care conversation.

Living with it

A long journey, best walked with a plan.

Four things that make the biggest difference day to day - the diagnosis, the routine, the carer and the plan.

A quiet reminder

Consistency beats intensity, every time.

Small, steady changes - kept up for months - do more than a heroic week that does not last.

  1. 01 Diagnosis

    Diagnosis is the doorway

    It unlocks medication, support, benefits and time to plan - not the end of the story.

  2. 02 Routine

    Small routines carry the day

    Predictable meals, sleep and activity reduce agitation and preserve function.

  3. 03 Carers

    Carers need care too

    Respite, peer groups and a named clinician are as important as the patient’s medication.

  4. 04 Planning

    Plan early, revisit often

    Power of attorney, advance wishes and future care - easier to set up while capacity is preserved.

Frequently asked

Everything we get asked about dementia.

Quick answers on diagnosis, medication, new anti-amyloid antibodies, prevention and driving.

  • What is the difference between dementia and Alzheimer’s?

    Dementia is the umbrella term for progressive cognitive impairment that affects daily life. Alzheimer’s disease is the most common cause - about 60% of cases. Vascular, Lewy body and frontotemporal dementia are the other main types.

  • How is dementia diagnosed?

    A cognitive screen (MoCA or ACE-III), a full history from patient and family, blood tests to exclude reversible causes and a brain MRI. Specialist tests - neuropsychology, CSF biomarkers or amyloid-PET - are added when the picture is unclear. The memory clinic MDT confirms the diagnosis.

  • What are the new anti-amyloid antibodies?

    Lecanemab and donanemab are monoclonal antibodies that clear amyloid from the brain. They modestly slow progression in early Alzheimer’s with confirmed amyloid pathology. They are specialist-only, require infusions and MRI monitoring, and carry a risk of brain swelling and bleeding.

  • Can dementia be prevented?

    Not entirely - but the Lancet Commission 2024 estimates up to 45% of cases are linked to modifiable risk factors across life: education, hearing, blood pressure, alcohol, obesity, smoking, depression, isolation, physical activity, diabetes, air pollution, head injury, cholesterol and untreated vision loss.

  • Are cholinesterase inhibitors worth taking?

    For most people with mild-to-moderate Alzheimer’s or Lewy body dementia, yes - they can modestly improve cognition and daily function for a period, with manageable side effects. They do not cure or reverse the disease.

  • When should someone with dementia stop driving?

    The DVLA must be told at diagnosis. Some people with mild dementia can continue for a period after an on-road assessment; others need to stop straight away. The clinician will guide this - honesty with the DVLA is a legal requirement.

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