Can Dementia Be Treated? Understanding Your Options

A diagnosis of dementia often brings an immediate question for individuals and their families: what happens now? While there is currently no cure for dementia, a diagnosis does not mean that nothing can be done. There are treatments and support that can help manage symptoms, maintain independence, and support quality of life.

Treatment for dementia takes many different forms, ranging from medications that temporarily help cognitive symptoms to non-drug therapies, environmental adaptations, and treatments for underlying health conditions. 

Today, around 1 million people in the UK are living with dementia. Understanding the different treatment and support options can help individuals and their families make informed decisions as their needs change.

Can Dementia Be Cured?

There is currently no cure for dementia, and existing treatments cannot reverse the damage that has already occurred in the brain. However, some treatments can help manage symptoms, while newer treatments for early Alzheimer’s disease aim to slow the progression of the disease.

Dementia is an umbrella term covering several distinct conditions, meaning that treatment relies heavily on the specific underlying cause. Some health conditions, nutritional deficiencies, and medicines can cause symptoms that affect memory, thinking, or behaviour and may sometimes be mistaken for dementia. Examples include vitamin B12 deficiency, thyroid problems, and certain medication side effects. Treating the underlying problem may improve these symptoms.

For progressive forms of dementia, modern treatments focus on three key goals:

• Managing symptoms: Reducing or managing symptoms such as memory problems, confusion, mood changes, or hallucinations where appropriate.
• Slowing progression: Targeting the underlying disease process or reducing risk factors that can contribute to further damage.
• Supporting wellbeing: Using tailored therapies, environmental changes, and care support to maintain independence, comfort, and quality of life.

Why Does the Type of Dementia Matter?

Different types of dementia affect the brain in distinct ways, requiring tailored treatment approaches:

• Alzheimer’s Disease: Treatment may include medicines for symptoms, psychological and cognitive interventions, support with daily activities and, for some people with early disease, newer disease-modifying treatments.
• Vascular Dementia: Treatment focuses largely on managing cardiovascular risk factors, such as high blood pressure, high cholesterol and diabetes, to reduce the risk of further strokes and vascular damage. 
• Dementia with Lewy Bodies (DLB): Some medicines may help with symptoms such as cognitive difficulties, hallucinations, or sleep problems, but treatment needs to take account of mobility symptoms and the person’s sensitivity to certain medicines.
• Frontotemporal Dementia (FTD): Treatment focuses largely on managing symptoms, supporting communication and adapting the person’s environment and care. Medicines commonly used for Alzheimer’s disease are not generally recommended for frontotemporal dementia.
• Mixed Dementia: Occurs when a person has features of more than one type (most commonly Alzheimer’s and vascular dementia), requiring a combination of treatment strategies.

Medicines for Dementia Symptoms

Some medicines can help manage symptoms of certain types of dementia. They work in different ways, and their potential benefits and side effects vary between individuals.

Cholinesterase Inhibitors

These medications prevent the breakdown of acetylcholine, a chemical messenger in the brain key to memory and learning. Donepezil, rivastigmine, and galantamine are used to manage symptoms of Alzheimer’s disease. Acetylcholinesterase inhibitors can also be used for dementia with Lewy bodies and Parkinson’s disease dementia, depending on the circumstances. 

They may provide a moderate improvement or temporary stabilisation of some symptoms for some people, but they do not stop the underlying disease. The National Institute for Health and Care Excellence (NICE) recommends that these treatments should not be discontinued simply because the condition advances to a more severe stage.

NMDA Receptor Antagonists

Memantine works differently by regulating the activity of glutamate, another chemical messenger involved in brain function. It is typically prescribed for moderate-to-severe Alzheimer’s disease, or when cholinesterase inhibitors are not suitable or cannot be tolerated.

Disease-Modifying Treatments for Alzheimer’s

Unlike traditional medications that manage symptoms, disease-modifying therapies target the Alzheimer’s disease itself.

Drugs such as lecanemab and donanemab are designed to target the protein that accumulates in the brains of people with Alzheimer’s. In a large clinical trial, lecanemab slowed the rate of cognitive decline and everyday functioning by 27% over 18 months in people with early Alzheimer’s disease.

It is important to note that these drugs do not reverse existing damage or restore lost memories. Rather, they aim to slow down the pace of decline in suitable candidates.

While disease-modifying treatments represent a major scientific shift, access in the UK is complicated. Eligibility criteria, specialist diagnostic requirements, NICE recommendations, and NHS commissioning arrangements all affect who can receive them.

Treating Underlying and Contributing Health Factors

Effective dementia treatment looks beyond cognitive symptoms to address physical health factors that impact brain function:

• Vascular risk management: Managing conditions such as high blood pressure, high cholesterol, diabetes, and cardiovascular disease can help reduce the risk of further vascular damage and stroke.
• Identifying intercurrent illnesses: Physical issues like urinary tract infections (UTIs), chest infections, dehydration, severe constipation, or unmanaged pain frequently cause acute confusion.

A sudden change in confusion, awareness or behaviour should not automatically be assumed to be a progression of dementia. Delirium can develop quickly and may be caused by infections, medication, or other medical problems. Sudden confusion requires urgent medical assessment.

Non-Drug Treatments and Psychosocial Therapies

Non-drug approaches form an important part of dementia care. Depending on the person’s needs, they can provide opportunities for cognitive stimulation, meaningful activity, communication, independence and social connection.

• Cognitive Stimulation Therapy (CST): Structured group sessions involving discussions, activities and exercises designed to stimulate thinking and memory. CST is ideal for people living with mild to moderate dementia.
• Cognitive rehabilitation: A personalised, goal-oriented approach that helps someone maintain or improve their ability to carry out specific everyday tasks.
• Occupational therapy: Helps people maintain independence in everyday activities, identify practical adaptations, and find strategies or equipment that make daily tasks safer and more manageable. 
• Reminiscence therapy: Uses photographs, music, objects, and other personal prompts to encourage conversation about someone’s past. It may support communication, social interaction, and a sense of identity. 
• Validation therapy: Focuses on acknowledging a person’s feelings and perspective rather than immediately correcting or challenging them. It may be used as part of supportive later-stage dementia care.
• Reality orientation: Uses information and environmental cues to help a person remain oriented to their surroundings, time, and place. Techniques may include calendars, clocks, signage and other familiar visual cues. 

Overview of Treatments

With many alternative therapies and supplements advertised online, consulting clinical guidelines helps distinguish proven interventions from unverified claims:

Managing Behavioral and Psychological Symptoms

Changes in behavior, such as agitation, physical restlessness, anxiety, depression, sleep disturbances, or hallucinations, are common as dementia progresses.

Before medication is considered, professionals should look for possible causes of distress and unmet needs. These may include pain, discomfort, infection, fear, boredom, loneliness, an unfamiliar environment, or difficulty communicating.

Antipsychotic medications such as risperidone may sometimes be prescribed when a person is experiencing severe distress or poses a risk of harm to themselves or others. They should only be used after other approaches have been considered, at the lowest effective dose and for the shortest possible time, with regular review. 

Lifestyle Factors Supporting Brain Health

Maintaining overall physical health directly supports cognitive function and daily wellbeing:

• Physical activity: Staying active can support physical health, mobility, mood and independence. Activities should be adapted to the person’s abilities and interests. 
• Nutritional support: Maintaining adequate nutrition and hydration is important for overall health. Where eating becomes difficult, changes such as adapted food, suitable utensils, or finger foods may help. 
• Social engagement: Maintaining relationships and taking part in meaningful social activities can support emotional wellbeing and help people remain connected to their communities. 

Dementia Care and Support as Part of Treatment

Treatment extends beyond medicines and clinical interventions. Person-centred care can include practical support at home, adaptations and daily living aids, respite for family carers, community services and, when appropriate, residential or nursing care. 

NICE recommends offering people living with dementia flexible, needs-based palliative care from diagnosis. This focuses on quality of life, symptom management, personal preferences and support for the person and those close to them. 

In a care home, these different forms of support can come together as part of a person’s individual care plan. This may include medication reviews, personalised activities, support with mobility and daily tasks, help with nutrition, meaningful social activities, and close communication with healthcare professionals and family members. 

Choosing the Right Path Forward

While dementia cannot currently be cured, it can be treated and managed through a combination of medical interventions, structured therapies, lifestyle adaptations, and compassionate care.

The most appropriate treatment plan will depend on the individual’s type of dementia, symptoms, physical health, preferences, and circumstances. Because these needs can change over time, treatment and care should be reviewed regularly and adapted where necessary to support their quality of life.