Medicines for Dementia

What it is

Dementia is not a single disease but a group of conditions in which the brain is progressively damaged, causing a lasting decline in memory, thinking, language, judgement and the ability to manage everyday life. Alzheimer's disease is the most common type; others include vascular dementia (linked to problems with blood supply to the brain), dementia with Lewy bodies, and frontotemporal dementia. The type matters, because they behave differently and are not all treated the same way. Beyond memory problems, dementia can affect mood, behaviour, sleep and perception, and people may at times become distressed, anxious or agitated. It mainly affects older people and tends to progress over time, although the pace varies. Diagnosis involves assessment of memory and thinking, a review of physical health, and sometimes brain scans, often through a specialist memory service.

How it is treated

Good dementia care centres on the person: understanding their needs, supporting daily living, and helping families and carers. Non-drug approaches come first and remain central throughout — a consistent routine, meaningful activity, a calm environment, and addressing pain, infection, hearing or vision problems and other reversible causes of distress. Medicines have a place mainly in Alzheimer's disease, where some can ease symptoms and help maintain function for a time, but they do not cure dementia or stop it progressing. A very important safety point concerns antipsychotic medicines: these are sometimes considered for severe distress or agitation, but only with great caution and as a last resort, because in people with dementia they carry serious risks, including stroke and increased death; they are used at the lowest level for the shortest time and reviewed often, and they can be especially harmful in dementia with Lewy bodies. Treatment is individualised to the type of dementia and reviewed regularly.