Memory Loss and Dementia

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Many people become forgetful as they become older. This is common and is often not due to dementia. There are also other disorders such as depression and an underactive thyroid that can cause memory problems. Dementia is the most serious form of memory problem. It causes a loss of mental ability, and other symptoms. Dementia can be caused by various disorders which affect parts of the brain involved with thought processes. Most cases are caused by Alzheimer's disease, vascular dementia, or dementia with Lewy bodies. Symptoms of dementia develop gradually and typically become worse over a number of years. The most important part of treatment for dementia is good-quality support and care for the person with dementia and for their carers. In some cases, treatment with medicines may be helpful.

Everybody forgets things from time to time. In general, the things that you tend to forget most easily are the things that you feel do not matter as much. The things that you tend to remember most easily are the things that are important to you - for example, a special birthday. However, some people just seem to have a better memory than others, and some people are more forgetful than others.

There are certain situations that can affect your memory and make you become more forgetful than you normally are. They can include the following.

Poor concentration

If your concentration is poor then you do not notice things as much, and do not retain things as much as you would normally. Poor concentration can be a result of simply being bored or tired. However, it can also be a symptom of depression and anxiety.


As well as poor concentration, some people with depression also have slowed thinking. This can cause memory problems until the depression clears. Do tell a doctor if you think that you are depressed, as treatment often works well. Other symptoms of depression include:

  • A low mood for most of the time
  • Loss of enjoyment and interest in life
  • Abnormal sadness
  • Weepiness
  • Feelings of guilt or of being useless
  • Poor motivation
  • Sleeping problems
  • Tiredness
  • Difficulty with affection
  • Poor appetite
  • Being irritable or restless

Physical illness

If you feel ill, this can affect concentration and memory. Certain illnesses can directly affect the way your brain works. For example, an underactive thyroid can slow down your body's functions, including your brain, and can make you more forgetful. Infections such as a chest infection or a urine infection can also cause sudden confusion and memory problems, particularly in older people.


Certain medicines can cause confusion and memory problems in some people. For example, some sedative medicines, some painkilling medicines, some medicines that are used to treat Parkinson's disease, or steroid medicines. Also, if you are taking lots of different medicines, this can increase the risk of them interacting with each other, causing problems, including confusion and memory problems.


As everyone gets older, it often becomes harder to remember things. This is called age-associated memory impairment. Many people over the age of 60 have this common problem, and it is not dementia. For example, it tends to be harder to learn new skills the older you become, or you may more easily forget the names of people you have recently met. It is thought that the more you use your brain when you are older, the more it may counter the development of this age-related decline in memory function. So, doing things such as reading regularly, quizzes, crosswords, memorising plays or poetry, learning new skills, etc, may help to keep your memory in good shape.


Dementia is the most serious form of memory problem. The rest of this leaflet is just about dementia.


Dementia can be caused by various diseases or disorders which affect the parts of the brain involved with thought processes. However, most cases are caused by Alzheimer's disease, vascular dementia, or dementia with Lewy bodies (DLB). All these types of dementia cause similar symptoms but some features may point to a particular cause. However, it may not be possible to say what is causing the dementia in every case.

Alzheimer's disease

This is the most common type of dementia, causing about half of all cases. It is named after the doctor who first described it. In Alzheimer's disease the brain shrinks (atrophies) and the numbers of nerve fibres in the brain gradually reduce. The amount of some brain chemicals (neurotransmitters) is also reduced - in particular, one called acetylcholine. These chemicals help to send messages between brain cells. Tiny deposits called plaques also form throughout the brain. It is not known why these changes in the brain occur, or exactly how they cause dementia. Alzheimer's disease gradually progresses (worsens) over time as the brain becomes more and more affected.

Blood vessel dementia (vascular dementia)

This causes about a quarter of all cases of dementia. It is due to problems with the small blood vessels in your brain. The most common type is called multi-infarct dementia. In effect, this is like having many tiny strokes, that otherwise go unrecognised, throughout the thinking part of the brain. A stroke occurs when a blood vessel blocks and stops the blood getting past. So, the section of brain supplied by that blood vessel is damaged or dies (an infarct occurs). After each infarct, some more brain tissue is damaged. So, a person's mental ability gradually declines. Vascular dementia can also sometimes happen after a more major stroke.

The risk of developing vascular dementia is increased by the same things that increase the risk of stroke. For example: high blood pressure, smoking, high cholesterol level, lack of exercise, etc. (See separate leaflet called Preventing Cardiovascular Diseases for more details.) However, it is now thought that some of these vascular risk factors may also be involved in the development of Alzheimer's disease and other types of dementia as well.

Lewy body dementia/dementia with Lewy bodies (DLB)

This causes about 15 in every 100 cases of dementia. Lewy bodies are tiny abnormal protein deposits that develop in nerve cells in the brain of people with this condition. It is not clear why the Lewy bodies develop but they interfere with the normal working of the brain.

If Lewy bodies develop in a part of the brain called the brain stem, as well as symptoms of dementia, someone may also develop symptoms similar to Parkinson's disease. For example, stiffness, slowness of movement and a shuffling walk with difficulty in starting, stopping, and in turning easily.

Mixed dementia

Some people can have a degree of two different types of dementia at the same time. For example, both Alzheimer's disease and vascular dementia, or both Alzheimer's disease and DLB. This is known as mixed dementia. However, in most cases of mixed dementia, there is usually one of the causes for dementia that is thought to be the main (predominant) cause. In this situation, treatment is aimed at the predominant cause of dementia.

Other causes of dementia

There are over 60 diseases which can cause dementia. Many are rare and, in many, the dementia is just part of other problems and symptoms. In most cases the dementia cannot be prevented or reversed. However, in some disorders the dementia can be prevented, or stopped from getting worse if treated. For example, some cases of dementia are caused by alcohol abuse, infections such as syphilis, or some vitamin deficiencies, all of which can be treated.

Dementia is a common problem. According to figures provided by the Alzheimer's society, there are currently 800,000 people with dementia in the UK. There are estimated to be over a million by 2021. The older you are the higher chance there is of getting dementia. Between the age of 65 and 74, 1-2 people in 100 will have dementia. By the age of 95, a quarter of people will have it. However, dementia is not a normal part of ageing. It is different to the age-associated memory impairment that is common in older people. Rarely, dementia affects younger people. Dementia is said to be early-onset (or young-onset) if it comes on before the age of 65. There are some groups of people who are known to have a higher risk of developing dementia. These include people with:

  • Down's syndrome or other learning disabilities. People with Down's syndrome are more likely to develop Alzheimer's disease.
  • Parkinson's disease.
  • Risk factors for cardiovascular disease (angina, heart attack, stroke and peripheral arterial disease). The risk factors for cardiovascular disease (high blood pressure, smoking, high cholesterol level, lack of exercise, etc) are risk factors for all types of dementia, not just blood vessel dementia (vascular dementia).
  • A family history of dementia. There is a small extra risk of getting dementia if you have a mother, father or sibling with dementia. Dementia also seems to run in some families so there may be some genetic factors that can make someone more likely to develop dementia. We do know that a few of the more rare causes of dementia can be inherited (can be passed on through genes in your family).
  • Severe psychiatric problems such as schizophrenia or severe depression. It is not clear why this is the case.
  • A past history of a head injury.
  • A limited social support network.
  • Low physical activity levels. A lack of physical activity can increase your risk of dementia. (See separate leaflet called Physical Activity for Health for more details.)


Loss of mental ability






Changes in mood, behaviour and personality




Problems carrying out day-to-day activities


The speed in which dementia progresses varies greatly from person to person. It can also depend on the type of dementia that someone has. Typically, symptoms of dementia tend to develop slowly, often over several years. In the early stages of the disease, many people with mild dementia cope with just a small amount of support and care. As the disease progresses more care is usually needed.

In the later stages of dementia, speech may be lost and severe physical problems may develop, including problems with mobility, incontinence, and general frailty. This can make people more susceptible to other health problems such as infections. Often, people with dementia die from another health problem such as a severe chest infection. So, the dementia isn't the cause of their death but has contributed to it.

Some people can live for many years after dementia has been diagnosed. However, a recent study showed that if someone is diagnosed with dementia between the ages of 60-69, on average it takes just under seven years to go from being diagnosed with dementia, to being severely affected, and ultimately to dying due to frailty of body and mind.

Because the symptoms of dementia tend to develop slowly, often over several years, they may be difficult to recognise at first. This can make dementia difficult to diagnose in some people. In the beginning, symptoms are often put down to other causes. There may also be a degree of protection by friends, carers and relatives who help the person to look after themself and, by doing so, cover up the person's inability.

Saying that, commonly, it is not the person with the symptoms but rather their relatives, carers or friends who have concerns that the person may have dementia. They may be concerned about the person's memory or behaviour. However, people with a high intellect or a demanding job, may notice themselves that their mental ability is starting to fail.

Visit your doctor




Referral to a specialist

Referral for the opinion of a specialist is usually needed to confirm the diagnosis of dementia. This is usually a specialist in the care of elderly people, a neurologist, or a psychiatrist specialised in looking after older people. The specialist may be able to determine the likely cause of dementia and decide if any specific treatment may be helpful (see below). To help with this, they may suggest further investigations such as an MRI scan of the brain.



New research

Research is underway to try to find ways of diagnosing dementia earlier and more easily, as well as to try to predict who may develop it. In particular, researchers made a breakthrough recently that could help diagnose Alzheimer's disease. They identified proteins (biomarkers) that seem to be present in the fluid that bathes the brain (the cerebrospinal fluid) in people who have Alzheimer's disease or may go on to develop Alzheimer's disease. This promising study gives hope but more research is needed in this area. More recently, other researchers have been looking into certain proteins that can be detected in the blood, which they think may help to determine a more accurate and earlier diagnosis of Alzheimer's disease. Again, this research shows good promise but further work is needed.

There is no cure for dementia and no medicine that will reverse dementia. However, there are some medicines that may be used to help in some causes of dementia. Medication is generally used for two different reasons. Firstly, as treatment to help with symptoms that affect thinking and memory (cognitive symptoms). Secondly, as treatment to help with symptoms that affect mood and how someone behaves (non-cognitive symptoms).

Acetylcholinesterase inhibitors


Previously, the National Institute for Health and Care Excellence (NICE) recommended that these medicines should only be considered for people with moderate Alzheimer's disease. This was quite controversial, as many people felt that they should also be available to those with mild Alzheimer's disease. However, NICE reviewed their guidance on the use of these medicines in March 2011. NICE now recommends that donepezil, galantamine and rivastigmine can be considered as treatment options for people with mild or moderate Alzheimer's disease, providing that:






NICE has also (March 2011) reviewed its guidance about the use of memantine and recommends that it can be considered as a treatment option for:

  • People who have severe Alzheimer's disease.

Other medication


There are several other medicines which have been suggested for the treatment of Alzheimer's disease. These include gingko biloba (a herbal medicine), non-steroidal anti-inflammatory drugs (NSAIDs), vitamin E, oestrogens and statins. However, there is currently not enough evidence from research trials to recommend any of these for the treatment or prevention of dementia. In particular, until recently, it was popular to take gingko biloba as a preventative treatment. Large research trials suggest that gingko biloba has little or no effect on preventing dementia. However, it may be helpful in improving memory for specific tasks such as remembering appointments.


When someone is diagnosed with dementia, a full assessment may be suggested to look at their practical skills, their ability to look after themself, their safety in their home, etc. This usually involves assessment by a number of different healthcare professionals (see below). An individual care plan may be drawn up that outlines the person's specific needs. The aim is to maintain the independence of someone with dementia as much as possible and for as long as possible.


  • People who can advise on financial and legal matters, such as lasting power of attorney.
  • Voluntary organisations can be a good source of advice. If you care for a person with dementia, it is well worth getting information about the help that is available in your local area. In most areas of the UK there are organisations that provide support and advice for carers of people with dementia. Your local library or citizens advice bureau will often have contact details. Some organisations are also listed at the end of this leaflet.


Many carers struggle on beyond the point that is appropriate. If you are a carer, you can ask a GP or district nurse to assess a person with dementia if you feel that you need a greater level of support. The Carer's Association (contact information listed below) may also be able to provide support and advice. For example, information about respite/short-break services for carers.

NICE has developed a pathway for dementia care. This is based on its publications called Quality Standards on dementia, and supporting people to live well with dementia. These documents contain a number of quality statements. These set out how people with dementia, and those who care for them, should be well looked after.

There are some other treatments and things that may be helpful for some people with dementia, particularly in certain situations. These include the following.


Reality orientation is thought to help in some cases. This involves giving regular information to people with dementia about times, places, or people to keep them orientated. It may range from simple things such as having a board in a prominent place, giving details of the day, date, season, etc to staff in a residential home reorientating a person with dementia at each contact.

Cognitive stimulation (stimulating the brain) may help to improve memory, language and problem-solving ability. For example, by recreational activities, problem-solving activities, and talking to the person with dementia. In addition, recreational activities may enhance quality of life and well-being.








At present, there are no specific medicines or treatments that are definitely known to reduce your chance of developing dementia. However, some things do show some promise.

As mentioned above, having risk factors for cardiovascular disease can increase your risk of developing all types of dementia. These risk factors include:

  • Smoking
  • Raised cholesterol levels
  • Drinking too much alcohol
  • Not doing enough physical activity
  • Being overweight
  • Having diabetes or high blood pressure


Keeping your brain active may also help to reduce your risk of developing dementia. So, for example, consider reading books, learning a foreign language, playing a musical instrument, taking up a new hobby, etc.

Many studies are going on to look into treatments which may help to prevent dementia. These include certain blood pressure medicines, omega-3 fatty acids, brain training exercises as well as the strategies discussed above. However, there is not yet convincing evidence available for any of these.


Original Author:
Dr Tim Kenny
Current Version:
Peer Reviewer:
Dr John Cox
Document ID:
4231 (v44)
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