Dementia

Dementia is a syndrome of progressive cognitive decline severe enough to interfere with daily life. Alzheimer's disease is the most common cause (≈ 60–70%), followed by vascular, Lewy body and frontotemporal dementias.^[1]NHS

The 2024 Lancet Commission identified less education, hearing loss, untreated vision loss, high LDL cholesterol, hypertension, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol, traumatic brain injury, air pollution and social isolation as modifiable risk factors that together could account for up to 45% of dementia cases.^{[4]Lancet Commission 2024}

NICE recommends a named care coordinator, post-diagnostic support, and offering acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) for mild-to-moderate Alzheimer's. Antipsychotics should be used only when patients are at risk of harming themselves or others, or experiencing severe distress.^{[3]NICE NG97}