Dementia and Memory Problems
Many of us become more forgetful as we get
older. Many of us will have 'mild cognitive impairment'.
Some of us will begin to develop more serious problems and may
worry that they are the first signs of dementia or Alzheimer’s
disease. This leaflet looks at some causes of poor
memory, and how to find help if you are worried about
your own memory or someone else’s.
Many things can affect our memory and dementia may not be the
problem. For instance, it is common to experience memory problems
as a result of stress, depression, grief and vitamin deficiencies.
Ask your doctor if you are worried about yourself or someone you
know with memory problems.
What is dementia?
Dementia is a general term used to describe a
loss of memory that keeps getting worse - or is 'progressive'.
There can be many different causes, they will all involve loss of
memory, but they have other symptoms which are different according
to the cause.
Dementia often starts off with just memory
problems, but can also involve:
- difficulty planning and carrying out
- difficulty communicating
- changes in mood, judgement or
As dementia is 'progressive', the
symptoms get worse over time. Someone with dementia
will become more dependent on others to help them as the
How common is dementia?
Dementia is a common. It currently affects 800,000 people in the
We are more likely to suffer from dementia as we get older.
- at the age of 65 about 5 in every 100 people will have
- by the age of 80 about 20 people in every 100 will have some
degree of dementia.
Dementia can sometimes occur in younger people and may run in
families, although this is rare.
What is Mild Cognitive Impairment?
Sometimes people will have problems with their memory which the
person may notice or which might be picked up by others. These
problems may not significantly affect the person's everyday life
and are not severe enough to be called dementia. This is called
Mild Cognitive Impairment (MCI).
Out of 100 people with MCI, about 4 people will develop dementia
in any one year. We can't yet identify those people who will go on
to develop dementia.
What can cause dementia?
There are different causes for dementia.
This is the most common cause of dementia and
accounts for about 7 in 10 of all dementias. It
typically begins with memory problems and slowly gets worse
over time. People will often notice that
they can't remember things that happened
recently even though they can still remember what happened years
ago. They will often find that they have difficulty recalling
particular words and naming objects.
They may also find it hard to:
- Learn new things.
- Remember recent events, appointments or phone
- Remember the names of people or
places. This can lead to problems with even simple daily
- Understand or communicate with others.
- Remember where they have put things. They may worry that
someone has been in their house or has taken things.
- Understand that there is anything wrong
with them. They may become cross when someone tries to help
Carers often comment that people with
Alzheimer’s show subtle changes to their personality. For
example, they might behave or react differently to how they did
before they became ill.
In Alzheimer's, damaged tissue seems to build up in the brain to
form deposits called 'plaques' and 'tangles'. These cause the brain
cells around them to die. The disease also affects the
chemicals in the brain which transmit messages from one cell
to another. The chemical most affected is acetylcholine.
This is usually caused by the blood
vessels supplying the brain becoming damaged or blocked.
This can lead to small strokes, or parts of the brain dying, as
they are starved of oxygen and nutrients. This dementia
can come on more quickly than Alzheimer’s. Someone with
vascular dementia is
more likely to suffer from conditions which
lead to blocked arteries, such as high blood pressure, smoking,
diabetes or high cholesterol.
It is difficult to predict how vascular
dementia will progress. There may be no further
problems for months or years, but then more strokes, or other
illnesses, can lead to further deterioration.
The problems caused by vascular dementia
depend on which part of the brain is affected.
- There may be memory loss and difficulty
- Word finding difficulties are common -
as they are in Alzheimer’s.
- It is common to suffer from mood swings or to
- Some people have episodes of confusion and
may be aggressive or distressed.
- Others may experience hallucinations (where
they see something that is not there).
- Sometimes there are physical problems, for
example difficulties with walking or incontinence.
It is possible for people to have a
combination of vascular and Alzheimer’s dementia. It can
hard, even for doctors, to tell the difference
between them. A brain scan can sometimes help.
This seems to be caused by protein deposits
(Lewy bodies) building up in the brain. This can lead to
symptoms which overlap with Alzheimer’s disease and
Parkinson’s disease. These include:
- Memory problems and difficulty planning
- Confusion which can vary during the course of
- Vivid visual hallucinations of people or
- Tremor, muscle stiffness, falls or difficulty
This dementia seems to affect the front of the
brain more than other areas. It often starts in people in
their 50s and 60s. Because it affects the front of the brain,
it is more likely to cause personality and behavioural changes. So
a person who is usually very polite and proper might start to
become irritable or rude.
There are many different causes for dementia
and these account for less than 5% of cases. Some of these are
- Corticobasal Degeneration
- Creutzfeldt-Jakob Disease
- HIV-related cognitive impairment
- Huntington's Disease
- Multiple Sclerosis
- Korsakoff’s Syndrome
- Normal Pressure Hydrocephalus
- Parkinson's Disease
- Posterior Cortical Atrophy
- Progressive Supranuclear Palsy.
How is dementia diagnosed?
Dementias are diagnosed by the pattern
of symptoms that a person has and the way in
which these symptoms affect how people cope from day to
So, the first step is an interview to look at the person's
thinking and memory using 'cognitive testing'. This can help to
identify problem areas and will often give clues as to the type of
Blood tests and scans may be used to look for
other reasons for these symptoms. Scans (CT/MRI scans) can help to
identify the type of dementia and this can guide any
Referral to a specialist ‘Memory Clinic’
is now common to help early diagnosis. The person may be seen
by a range of professionals - psychiatrists, geriatricians,
psychologists and nurses.
Who is at risk?
Any of us can develop a dementia - we all
have to get older. But, some medical conditions can make it
more likely that we will develop dementia. These include
strokes, heart disease and high blood pressure. Poor diet and
a lack of exercise may make these diseases more likely.
Lifestyle can affect our risk. Smoking and
drinking heavily make memory loss more rapid in old age.
People who drink heavily as young adults
and in middle age are more likely to develop
a Korsakoff’s syndrome.
Genes also play a part in dementia. In
Alzheimer’s disease and Fronto-temporal dementia, some of these
genes have been found. If a brother or sister or a parent has
had Alzheimer’s disease after the age of 65, then
your risk of developing dementia is twice that of the rest of
the population. This does not mean that you will develop dementia - but there is
no test (yet) which can predict this.
In some families, members tend to develop
‘early onset dementia’, so there seems to be a stronger genetic
cause in these cases. So, if there has been more than one
person in your family with a dementia starting before the
age of 65, it could be worthwhile seeking advice from a
Are there any treatments?
This will depend on the diagnosis and your
circumstances. Unfortunately, there are no cures for these
It is important to help someone with dementia
stay as independent and as mobile as possible, for as long as
possible. A psychological treatment called group cognitive
stimulation has been shown to help with memory and improve
the quality of a person's life.
Reminiscence Therapy involves
the discussion of past activities, events and experiences with
another person or group of people. This has been shown to have
beneficial effects on both understanding and knowledge
(cognition), and in reducing the strain on
A group of drugs called
Acetylcholinesterase Inhibitors and another drug
called Memantine that can treat some of the
symptoms of Alzheimer's dementia, and help people to maintain their
independence for longer. These drugs may also be helpful in
Lewy Body Dementia, particularly if hallucinations are a problem.
See our leaflet on 'Drug
treatment of Alzheimer's disease'.
In Vascular dementia, it can be helpful to
take a small dose of aspirin to prevent further strokes.
Your GP may also suggest taking medication if you
have high blood pressure or raised cholesterol. It is also helpful
to stop smoking, eat healthily and take regular exercise.
I have dementia - how can I help other
There is lots of research happening, in the UK
and around the world, into the causes of dementia and how to treat
There are currently 3 major Research Networks
operating in the UK;
- England - Dementias &
Neurodegenerative Diseases Research Network (DeNDRoN)
- Scotland - The Scottish Dementia Clinical
Research Network (SDCRN)
- Wales - The Wales Dementias and
Neurodegenerative Diseases Research Network (NEURODEM
These organisations can be contacted directly
or you can ask your GP or local mental health team what research is
Brains for Dementia
Research was established in 2007 to promote brain donation
and establish a network of brain banks to facilitate research into
dementia. They invite people diagnosed with a memory impairment (or
dementia) to participate in monitoring memory, thinking and
behaviour prior to brain donation. They also invite those who do
not have a memory impairment to take part, as normal brain tissue
is essential for comparison.
How can I help myself?
Simple practical steps
- Use a diary to help you remember
- Make lists.
- Keep your mind active by reading or doing
crossword puzzles, Sudoku’s and other mind exercises.
- Stay involved and connected – find your local
physical exercise (it can help whatever your age)
- Eat a healthy diet (supplements such as
Vitamin E and Ginkgo Biloba are not currently recommended).
There may come a time when it is difficult to
make decisions about important matters in your life, such as
managing finances or medical decisions. You can give a trusted
relative, friend or solicitor the right to make such decisions
on your behalf if you cannot. This is called a Lasting
Power of Attorney (LPA). A solicitor can help you arrange
There are 2 types of LPA - one for the
management of ‘Property and Financial Affairs’, and another for
matters involving ‘Health and Welfare’.
Property and financial affairs LPA - Attorneys can be appointed
to make decisions about such things as banking and investments,
property sales, tax and benefits.
Health and welfare LPAs - Attorneys can be appointed to make
decisions about such things as medical treatment, day-to-day care
and place of residence.
All LPAs must be registered with the Office of the Public
Guardian before they can be used.
Note re: Enduring Power of Attorney (EPA): the LPA has now
replaced the EPA. However, valid EPAs that were executed before 1
October 2007 will continue to be valid, even if they have not yet
Advance Decisions - it is possible to make
known decisions to refuse certain medical treatments in the future
should you lose the capacity to make decisions. These will be
respected by the professionals providing care. This can be
made at the same time or separately from a LPA.
This is me
For people with memory problems, it is
important that professionals can easily see important information
about them. ‘This is Me’ is a document that can be completed
for this purpose. It has lots of useful information about
people's medical history, their life and preferences. It can
travel with them to appointments or hospital admissions and is
This is Me
Depression and anxiety
People with dementia commonly become depressed
and anxious. But, it is also possible for depression to look
like a dementia. Like dementia it will affect a person's ability to
look after themselves. This is called ‘pseudo-dementia' and
it is important to identify it and treat it. If you are
concerned that you or a relative may be depressed, seek advice from
your GP in the first instance. Depression can be treated with
Getting help and support
If you are worried about your memory, make an
appointment to see your GP. They may do some simple tests to
check your memory, and perhaps organise some blood tests. If
needed, your doctor can refer you to a specialist team, a
psychologist or a specialist doctor. These people can carry
out more detailed tests and arrange a brain scan if needed.
Some areas have memory clinics where
these assessments are carried out. Also see below for other
organisations that can provide information and support.
If you need help with practical activities and
day-to-day care or benefits, you can contact your local authority
for advice about social care and carer support services.
Other sources of information and helpful
NHS Choices: links to local services and information about
National Helpline of advice and support: 0300
222 11 22.
The National Dementia Helpline provides
information, advice, and support through listening, guidance and
appropriate signposting to anyone affected by dementia.
The Age UK Group works to improve later
life for everyone by providing life-enhancing services and vital
support. Call Age UK: 0800 169 8787; Email: email@example.com
Advice Line: 0808 808 7777. Carers UK supports
carers who are providing unpaid care for friends or relatives.
The Citizen’s Advice Bureau offer free,
confidential and independent advice. Contact your local
office for assistance with benefits, financial planning or
The Law Society
The Law Society have lots of useful
information about the legal issues involved in making a Power of
Attorney or Advance Decisions and can be a useful resource for
finding a solicitor to help.
Making an application to the Court of Protection
If you know or care for someone who is having
difficulties making decisions about their personal health, finance
or welfare, you may need to apply to the Court of Protection so
that you (or someone else) can make decisions for them.
of the Public Guardian
An agency with responsibilities that extend across England and
Wales (separate arrangements exist for Scotland and for Northern
Ireland). It supports the Public Guardian in the registration of
Enduring Powers of Attorney (EPA) and Lasting Powers of Attorney
(LPA), and the supervision of deputies appointed by the Court of
The following sources were used to compile this
- Alzheimer's and Other Dementias: answers
at your fingertips. Cayton, Graham, & Warner. Class
Publishing (London) Ltd. 3rd edition 2008.
- Your Memory: a users guide.
Baddeley. Carlton Books (London). Revised edition 2004.
- Dancing with Dementia: My story of living
positively with dementia. Bryden. Jessica Kingsley
Publishers (London & Philadelphia). 2005.
This leaflet was produced by the Royal College of
Psychiatrists' Public Education Editorial Board.
Series editor: Dr Philip Timms.
Written by: Dr Thomas Manders and Dr
© October 2013. Review date: October 2015. Royal
College of Psychiatrists. This leaflet may be downloaded,
printed out, photocopied and distributed free of charge as long as
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