Dementia: key facts
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. It is
much more common in older people. Dementia can sometimes occur in
younger people and may run in families, although this is rare.
What causes dementia?
Alzheimer’s disease is the
commonest cause of dementia. 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
Vascular dementia is
when 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 you are a smoker or if you have high blood pressure, diabetes or
Lewy body dementia seems to
be caused by protein deposits (Lewy bodies) building up in the
dementia seem to affect the front of the brain more
than other areas. It often starts in people in their 50s and
Mild cognitive impairment is
a term used when memory problems are more than you would expect for
your age, but not bad enough to be called dementia. About 1 in 3
people with this problem may develop dementia, but we can't yet
predict who these people will be.
Other illnesses that can cause memory
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 does it feel like to have dementia?
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 and reacts differently to how they did before they
Alzheimer's disease produces particular
problems with memory and thinking. Learning new information becomes
harder - you can't remember recent events, appointment 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.
On Vascular dementia, problems will depend on
which part of the brain is affected. There may be memory loss, poor
concentration, word finding difficulties, mood swings and
depression. Some people have hallucinations (where they see or hear
something that is not there). Physical problems can develop, such
as difficulties with walking and incontinence.
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 deterioration.
Lewy body dementia causes 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 trembling hands, muscle stiffness, falls or difficulty in
Because fronto-temporal dementia 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 and rude.
Treatments that can help
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.
Treatment will depend 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
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.
How you can help yourself
- Use a diary to help you remember
appointments and make lists.
- Keep your mind active by reading or doing crossword puzzles,
Sudokus 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.
Charities such as the Alzheimer’s Society are 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.
Plan for the future
There may come a time when it is difficult to make decisions
about managing finances or medical decisions. You can give a
trusted relative, friend or solicitor the right to make such
decisions on your behalf when you cannot. This is called a
Lasting Power of
Attorney (LPA). A solicitor can help you to arrange an
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.
How other people can help
- Others may notice early symptoms, so they can help by
encouraging you to talk to your doctor. The earlier you are
diagnosed the better.
- Help you to remember things by prompting you.
- Encourage and help you to continue doing the things you have
- Be patient and not do things for you because it is
- Help you adapt your lifestyle and maintain your
- Explain things that you don't understand.
For more in-depth information see our main leaflet:
Dementia and Memory
This leaflet reflects the most up-to-date evidence at the time
Produced by the RCPsych Public Education Editorial Board.
Series Editor: Dr Philip Timms
Reviewed by Elaine Ellis and Dr Svetlana Hemsley
© October 2014. Due for review: October 2017. Royal
College of Psychiatrists. This leaflet may be downloaded,
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