Dementia and Alzheimer’s Disease: Symptoms, Types, NHS Treatment and Carer Support

Dementia is an umbrella term for a group of progressive neurological disorders that affect memory, thinking, behaviour, and the ability to perform everyday tasks. It affects approximately 900,000 people in the UK — a figure projected to rise to 1.6 million by 2040. Alzheimer’s disease is the most common type, accounting for around 60–70% of all dementia cases. Dementia is the leading cause of death in England and Wales, and it places enormous demands on NHS and social care services, as well as on family carers.

Types of Dementia

Alzheimer’s Disease (60–70% of cases)

Caused by abnormal protein deposits in the brain — amyloid plaques and tau tangles — that disrupt nerve cell communication and cause brain cells to die. Alzheimer’s typically progresses slowly over years. Memory loss, particularly of recent events, is usually the first symptom.

Vascular Dementia (15–20%)

Caused by reduced blood flow to the brain — usually from strokes or small vessel disease. See our stroke guide. Often has a “stepwise” progression rather than the gradual decline seen in Alzheimer’s. Symptoms may include problems with planning, speed of thinking, and concentration.

Lewy Body Dementia (DLB, ~10%)

Caused by Lewy body protein deposits in brain cells. Characterised by: fluctuating cognition, vivid visual hallucinations, REM sleep behaviour disorder, and Parkinsonism (tremor, rigidity). Crucially, people with DLB can have severe reactions to antipsychotic medications — this must be documented clearly in all care plans.

Frontotemporal Dementia (FTD)

Affects the frontal and temporal lobes; more common in people under 65 (“young-onset dementia”). Often presents with personality change, disinhibition, and language difficulties rather than memory problems — frequently misdiagnosed as depression or psychiatric disorder.

Mixed Dementia

Having features of two types simultaneously — most commonly Alzheimer’s and vascular dementia.

UK Statistics

  • 900,000 people in the UK currently live with dementia
  • 1 in 14 people over 65 has dementia; 1 in 6 over 80
  • 70,000 people in the UK under age 65 have young-onset dementia
  • Dementia costs the UK £34.7 billion per year — more than cancer and heart disease combined
  • Two thirds of people with dementia live in the community, cared for by approximately 700,000 unpaid family carers
  • Dementia is the leading cause of death in England and Wales for women

Symptoms and Progression

Early Signs to Watch For

  • Repeatedly asking the same questions or telling the same stories
  • Forgetting recent events, names, or appointments (while long-term memories remain intact)
  • Getting lost in familiar places
  • Difficulty finding the right words
  • Problems with planning, organising, or following instructions
  • Changes in personality, mood, or behaviour
  • Poor judgement or decision-making
  • Withdrawal from social activities

If you are worried about your own memory or that of someone you know, see a GP. Treatable causes of memory problems (depression, thyroid disorders, vitamin B12 deficiency, medication side effects, urinary tract infections) must be excluded before a dementia diagnosis is made.

Diagnosis: The NHS Pathway

NICE guideline NG97 recommends that all people with suspected dementia are referred to a specialist memory service for assessment. The diagnostic process includes:

  • Cognitive assessments — MMSE (Mini Mental State Examination), MoCA (Montreal Cognitive Assessment), ACE-III (Addenbrooke’s Cognitive Examination), or 6-CIT (Six-Item Cognitive Impairment Test)
  • Blood tests — to exclude reversible causes: thyroid function, vitamin B12/folate, FBC, glucose, calcium, LFTs, renal function, CRP
  • Brain imaging — CT or MRI to identify vascular changes, atrophy, or alternative diagnoses; MRI preferred for DLB and FTD
  • Specialist assessment — by a consultant psychiatrist, neurologist, or geriatrician at a memory clinic

Emerging Biomarker Tests (UK 2024–2025)

Blood-based Alzheimer’s biomarkers — particularly plasma phosphorylated tau 217 (p-tau217) — are becoming available through NHS research pathways and may soon transform diagnosis. The Alzheimer’s Society anticipates routine blood biomarker testing for Alzheimer’s could become available via the NHS within the next few years, enabling earlier diagnosis before significant symptoms develop.

NHS Treatment for Dementia

Medications

Currently available drugs do not stop or reverse dementia — they provide modest symptomatic benefit by increasing neurotransmitter levels in the brain:

  • Cholinesterase inhibitors — donepezil (Aricept), rivastigmine (Exelon), galantamine (Reminyl); NICE-approved for mild-moderate Alzheimer’s and DLB; modest benefit on cognition and daily function
  • Memantine — NMDA receptor antagonist; NICE-approved for moderate-severe Alzheimer’s or as alternative if cholinesterase inhibitors not tolerated; also beneficial in DLB

Disease-Modifying Treatments (Emerging)

Lecanemab (Leqembi) — an anti-amyloid monoclonal antibody — received FDA approval in 2023 and showed modest slowing of Alzheimer’s progression in clinical trials. As of 2025, NICE has issued guidance on lecanemab; access via NHS is being evaluated. Donanemab (Kisunla) similarly received regulatory attention. These represent the first class of drugs that target the underlying Alzheimer’s disease process — a historic milestone, though with significant side effects (brain microbleeds) and limited applicability to early Alzheimer’s only.

Non-Pharmacological Support

  • Cognitive stimulation therapy (CST) — group activities; NICE-recommended; evidence of benefit comparable to drug treatment
  • Occupational therapy — adapting the home environment; assistive technology; activity planning
  • Reminiscence therapy
  • Physical activity — moderate exercise slows cognitive decline and reduces neuropsychiatric symptoms
  • Post-diagnostic support — NHS memory services provide structured support following diagnosis

NHS Rights After a Dementia Diagnosis

  • Care and support needs assessment — local authority social services must assess needs and eligibility for funded support
  • Carers’ assessment — family carers are entitled to their own assessment and support
  • Lasting Power of Attorney (LPA) — organise while the person still has mental capacity; essential for future decisions; free guidance from the Office of the Public Guardian (gov.uk/power-of-attorney)
  • NHS Continuing Healthcare (CHC) — for those with complex health needs; fully funded NHS care; assessment via GP or hospital team
  • Attendance Allowance / PIP — benefits available for people with dementia
  • DVLA notification — mandatory to notify DVLA if you have a diagnosis of dementia; you may be permitted to continue driving while assessed as safe

Reducing Your Dementia Risk: What the Evidence Shows

The Lancet Commission on dementia prevention (2020, updated 2024) identified 14 modifiable risk factors responsible for approximately 45% of all dementia cases:

  • Control high blood pressure — especially in midlife; see our hypertension guide
  • Manage hearing loss — use hearing aids; the strongest single modifiable risk factor
  • Stay physically active
  • Avoid smoking
  • Manage obesity
  • Limit alcohol
  • Protect your head — wear helmets; avoid traumatic brain injury
  • Control diabetes — see our type 2 diabetes guide
  • Reduce depression — see our anxiety and depression guide
  • Stay socially and cognitively active
  • Reduce air pollution exposure
  • Manage high LDL cholesterol — particularly in midlife; see our cholesterol guide
  • Address vision loss
  • Reduce social isolation

UK Support and Resources

  • Alzheimer’s Society — alzheimers.org.uk | Dementia Connect helpline: 0333 150 3456 | UK’s leading dementia charity
  • Dementia UK — dementiauk.org | Admiral Nurse helpline: 0800 888 6678 | Specialist dementia nurses
  • Alzheimer’s Research UK — alzheimersresearchuk.org | Research charity funding dementia science
  • Carers UK — carersuk.org | Helpline: 0808 808 7777 | Support for unpaid carers
  • Age UK — ageuk.org.uk | Advice line: 0800 678 1602 | Practical support for older people with dementia

What Major Health Sites Often Miss About Dementia

1. The Antipsychotic Danger in Lewy Body Dementia

People with Lewy Body Dementia (DLB) can have severe, potentially fatal reactions to antipsychotic medications (including haloperidol, risperidone, olanzapine) — including profound sedation, neuroleptic malignant syndrome, and accelerated cognitive decline. This critical safety issue is frequently unknown to hospital staff and out-of-hours doctors who may prescribe antipsychotics for agitation or hallucinations without knowing the specific dementia subtype. If a family member has DLB, ensure it is prominently documented in their medical records, medication list, and any hospital admission paperwork.

2. Lasting Power of Attorney — Act Early, While Capacity Exists

Setting up a Lasting Power of Attorney (LPA) must be done while the person with dementia still has mental capacity to consent. Once capacity is lost, the process requires a far more costly and lengthy Court of Protection application. The Office of the Public Guardian provides free guidance and LPA application forms at gov.uk. The UK’s LPA framework is more nuanced than most countries’ equivalent systems — the distinction between Property and Financial Affairs LPA and Health and Welfare LPA is particularly important for families to understand early.

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