Dementia: key facts
What is dementia?
We all tend to get more forgetful as we get
older. But dementia is different. It is a brain disease which often
starts with memory problems, but goes on to affect many other parts
of the brain, producing:
- difficulty coping with day to day tasks
- difficulty communicating
- changes in mood, judgment or personality.
It usually gets worse over time. With
dementia you tend to have to rely on other people more and more as
the illness progresses. It is much more common in older
people, but can start as early as 40.
About 1 in every 20 over-65s have dementia and
by the age of 80 about 1 in 5 will have some degree of
What causes dementia?
Alzheimer’s disease is the
commonest cause. Damaged tissue builds up in the brain to form
deposits called ‘plaques’ and ‘tangles’. These cause the brain
cells around them to die.
Alzheimer's also affects the chemicals in the
brain which transmit messages from one cell to another,
particularly acetylcholine. It comes on gradually and develops
slowly over several years. It can sometimes run in families
and it is more likely to affect people with Down’s syndrome.
Alzheimer’s disease produces particular
problems with memory and thinking. Learning new information becomes
harder – you can't remember recent events, appointments or phone
You may forget the names of people or places
and may struggle to understand or communicate with others.
Commonly, you just can't find the right word for objects or people
you know well. This can make you frustrated and depressed. You may think that
people have taken or stolen your things when all that has
happened is that you have lost them.
Sometimes people with dementia do not feel
there is anything wrong with them and get cross when people try to
help. Carers often comment that the Alzheimer’s has changed
the personality, so the person behaves or reacts differently to how
they did before they became ill.
Vascular dementia - the
arteries supplying blood to the brain become blocked. This
leads to small or big strokes - parts of the brain die as they
are starved of oxygen. It is more common if if you are a
smoker or if you have high blood pressure, diabetes or high
It is difficult to predict how fast your
brain functions will deteriorate. It can be stable for several
months or years but then, when more strokes happen, you get further
The problems caused by vascular dementia will
depend on which part of the brain is affected. There may be
memory loss, poor concentration, word finding difficulties, mood
swings or depression. Some people have hallucinations (where
they see or hear something that is not there). Physical
problems can develop, such as difficulties with walking or
Lewy body dementia - People
with Lewy body dementia have symptoms which overlap with
Alzheimer’s disease and Parkinson’s disease. The level
of confusion can vary during the course of the day, but visual
hallucinations of people or animals are more common. They may
also have a tremor, muscle stiffness, falls or difficulty with
Fronto-temporal dementia – if
the dementia affects the front of the brain more than other areas,
it is more likely to cause personality changes as well as memory
Other causes of memory decline
Many other illnesses can cause memory
- Depression can cause a 'pseudo-dementia'
which can get better with antidepressants and talking therapy.
- Heavy alcohol drinking.
- Physical illnesses which cause memory
- kidney, liver or thyroid problems
- shortage of some vitamins (rare), diabetes
- chest or urine infections can lead to confusion and can be
treated with antibiotics
- rarer conditions such as Huntington’s disease, which causes
dementia in younger people.
What is mild cognitive impairment?
Many of us worry about our memory as we get
older. This term is used when the problem is more than you
would expect for your age but not bad enough to be called
Out of 10
people, about 1 in 3 with this problem may develop dementia,
but we can't yet predict who these people will be.
If you are worried about your memory, see your
doctor. He or she can do a simple memory test, a physical
examination and order blood tests. They can then refer you
to a specialist team or a memory clinic who will test your
memory in more detail and arrange a brain scan if needed.
Simple practical steps to help with memory
- Use a diary to help you remember
appointments and make lists.
- Keep your mind active by reading or doing crossword puzzles,
Sudoku’s and other mind exercises.
- Get regular physical exercise (it can help whatever your
- Eat a healthy diet. Supplements such as Vitamin E and Ginkgo
Biloba don't seem to help.
This depends on the diagnosis and your
circumstances. Unfortunately there are no cures for many of
There is a group of drugs called acetyl
cholinesterase inhibitors which may slow the progression of
Alzheimer’s dementia (see our
factsheet). These drugs may also help in Lewy Body
dementia if hallucinations are a problem. In Vascular
dementia, a small dose of aspirin may help to prevent further
strokes or medication may help to control high blood pressure or
raised cholesterol. It is also important to stop smoking, eat
healthily and take exercise.
Planning for the future
Discuss any worries you have with your doctor,
mental health nurse or social worker.
Charities such as the Alzheimer’s Society are
also a very useful source of advice. A mental health nurse
can help you understand more about the illness. They can give
advice about medication and other help available. Social
services can help with home helps, meals at home or day care. You
may be entitled to benefits. You may also wish to complete a
Lasting Power of Attorney. This means that someone you trust
can look after your affairs when you find that you can't do this
You may also write an Advance Directive to let the doctors know
what types of treatment you would not want to have at the end of
For more in-depth information see
our main leaflet.
This is an abridged version of our main leaflet.
© June 2013. Due for review: June 2015.
Royal College of Psychiatrists. You can link to, download, print,
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Please note that we are unable to offer advice on individual cases. Please see our
advice on getting help.
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