Dementia is a syndrome resulting from brain disease, characterised by a global cognitive decline, which may include disturbances of thinking, memory, comprehension and orientation.

Symptoms can vary, depending on the cause, but memory difficulties are often the first problem to be noticed. There is sometimes a change in personality with alterations in behaviour, termed ‘BPSD’ (behavioural and psychological symptoms of dementia).

There are several types of dementia. We could talk about each in much greater detail, but in summary the most prevalent types are:

  • Alzheimer’s disease (most common form of dementia)
  • Lewy body dementia
  • Vascular dementia
  • Frontotemporal dementia
  • Rarer causes e.g. HIV, vitamin B12 deficiency, etc

What we already know

Screening and diagnosis of dementia has much improved over the last few years, with many areas of the country having a specific ‘memory clinic’ service, although controversy remains about which instrument to use to diagnose dementia.

The management of dementia includes both pharmacological treatment and non-pharmacological considerations (e.g. ensuring the environment is appropriate, providing activity and stimulation and addressing communication needs).

The use of acetylcholinesterase inhibitors has become much more widespread over recent years and, although it is no wonder drug or cure, for some people with Alzheimer’s, it can slow the progression of the disease. NICE guidelines recommend the use of Donepezil, Galantamine or Rivastigmine for mild-moderate Alzheimer’s disease. Mematine is recommended as an option for those with moderate Alzheimer’s disease who cannot tolerate acetylcholinesterase inhibitors, or for those with severe Alzheimer’s disease.

Areas of uncertainty

What actually causes dementia? We know lots of factors and even some genetic changes that are associated with dementia but we know little about the actual direct causes of dementia.

There is also uncertainty about the reason that some people progress from Mild Cognitive Impairment (memory impairment that does not meet diagnostic threshold of dementia) to dementia and how to predict who this will happen to.

What’s in the pipeline

Media reports often hint at a progression towards finding a cure for dementia. In practice we may not be that close, but there are several areas that researchers are working on:

  • Gene therapy
  • A vaccine for dementia
  • The use of stem cells to develop replacement cells lost in dementia


Giebel, C. M., Sutcliffe, C., Stolt, M., Karlsson, S., Renom-Guiteras, A., Soto, M., … Challis, D. (2014). Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study. International Psychogeriatrics / IPA, 26(8), 1283–93. doi:10.1017/S1041610214000775 [Abstract]

NICE guidelines CG42 (2015) “Dementia: Supporting people with dementia and their carers in health and social care” [PDF]

Semple, D. and Smyth, R. (eds.) (2013) Oxford Handbook of Psychiatry. 3rd ed. Oxford: Oxford University Press. [Publisher]


Written by: Josephine Neale
Reviewed by:
Last updated: Sep 2015
Review due: Sep 2016

Our dementia Blogs

Living positively with dementia: findings from a qualitative systematic review


Clarissa Giebel finds a lot to discuss in a recent qualitative systematic review about living positively with dementia.

[read the full story...]

German lessons for dementia care mapping in England?


Clarissa Giebel assesses a study from her native Germany into the effectiveness of dementia care mapping for improving quality of life in nursing homes.

[read the full story...]

CBT for anxiety in dementia


Raluca Lucacel summarises a recent pilot randomised controlled trial of CBT for anxiety in dementia, which aims to find out if a cognitive behavioural therapy manual can be used to treat anxiety in people with dementia.

[read the full story...]

Testing stress training for black and minority ethnic carers of people with dementia


Mary Larkin finds out if a US carer support programme is effective for black and minority ethnic carers of people living with Alzhemier’s disease.

[read the full story...]

The meanings of dementia care settings through dress

'It is important to see that ‘dressing’ is not the only time care home staff and residents manage clothing and accoutrements.

In this blog, Jill Manthorpe finds out how a ‘cultural gerontology’ study into dementia and dress can help with good practice in residential and nursing homes.

[read the full story...]

Population screening for dementia


Rosalyn Nelson reports on a recent systematic review about population screening for dementia, which highlights the negative attitudes of patients, carers and health care professionals towards screening. She asks: what are the risks of ignoring diagnosis?

[read the full story...]

Organisational co-production and social prescribing for dementia

CC Image courtesy of Vic Gedris via Flickr

Mike Clark considers some of the challenges of organisational co-production revealed by a study on social prescribing for people living with dementia.

[read the full story...]

Dementia and hospitalisation: how do family carers respond?


Clarissa Giebel analyses an Australian qualitative study into family carer feelings and responses, when their loved one with dementia is admitted to hospital.

[read the full story...]

Smoking is associated with an increased risk of dementia


Caroline Struthers reports on a recent meta-analysis, which finds that smoking is associated with an increased risk of dementia. The review finds that quitting smoking reduces the risk to the same level as those who have never smoked.

[read the full story...]