Dementia symptoms and diagnosis: symptoms and causes

Find out about the main symptoms of dementia, how to get diagnosed and what to do if you've been diagnosed.

Symptoms of dementia

Dementia is not a disease itself. It's a collection of symptoms that result from damage to the brain caused by different diseases, such as Alzheimer's. These symptoms vary according to the part of the brain that is damaged.

Common early symptoms of dementia

Different types of dementia can affect people differently, and everyone will experience symptoms in their own way.

However, there are some common early symptoms that may appear some time before a diagnosis of dementia. These include:

memory loss
difficulty concentrating
finding it hard to carry out familiar daily tasks, such as getting confused over the correct change when shopping
struggling to follow a conversation or find the right word
being confused about time and place
mood changes

These symptoms are often mild and may get worse only very gradually. It's often termed "mild cognitive impairment" (MCI) as the symptoms are not severe enough to be diagnosed as dementia.

You might not notice these symptoms if you have them, and family and friends may not notice or take them seriously for some time. In some people, these symptoms will remain the same and not worsen. But some people with MCI will go on to develop dementia.

Dementia is not a natural part of ageing. This is why it's important to talk to a GP sooner rather than later if you're worried about memory problems or other symptoms.

Symptoms specific to Alzheimer's disease

The most common cause of dementia is Alzheimer's disease. Common symptoms of Alzheimer's disease include:

memory problems, such as regularly forgetting recent events, names and faces
asking questions repetitively
increasing difficulties with tasks and activities that require organisation and planning
becoming confused in unfamiliar environments
difficulty finding the right words
difficulty with numbers and/or handling money in shops
becoming more withdrawn or anxious

Symptoms specific to vascular dementia

Vascular dementia is the second most common cause of dementia, after Alzheimer's. Some people have both vascular dementia and Alzheimer's disease, often called "mixed dementia".

Symptoms of vascular dementia are similar to Alzheimer's disease, although memory loss may not be as obvious in the early stages.

Symptoms can sometimes develop suddenly and quickly get worse, but they can also develop gradually over many months or years.

Specific symptoms can include:

stroke-like symptoms: including muscle weakness or temporary paralysis on one side of the body (these symptoms require urgent medical attention)
movement problems – difficulty walking or a change in the way a person walks
thinking problems – having difficulty with attention, planning and reasoning
mood changes – depression and a tendency to become more emotional

Symptoms specific to dementia with Lewy bodies

Dementia with Lewy bodies has many of the symptoms of Alzheimer's disease, and people with the condition typically also experience:

periods of being alert or drowsy, or fluctuating levels of confusion
visual hallucinations (seeing things that are not there)
becoming slower in their physical movements
repeated falls and fainting
sleep disturbances

Symptoms specific to frontotemporal dementia

Although Alzheimer's disease is still the most common type of dementia in people under 65, a higher percentage of people in this age group may develop frontotemporal dementia than older people. Most cases are diagnosed in people aged 45-65.

Early symptoms of frontotemporal dementia may include:

personality changes – reduced sensitivity to others' feelings, making people seem cold and unfeeling
lack of social awareness – making inappropriate jokes or showing a lack of tact, though some people may become very withdrawn and apathetic
language problems – difficulty finding the right words or understanding them
becoming obsessive – such as developing fads for unusual foods, overeating and drinking

Symptoms in the later stages of dementia

As dementia progresses, memory loss and difficulties with communication often become severe. In the later stages, the person is likely to neglect their own health, and require constant care and attention.

The most common symptoms of advanced dementia include:

memory problems – people may not recognise close family and friends, or remember where they live or where they are
communication problems – some people may eventually lose the ability to speak altogether. Using non-verbal means of communication, such as facial expressions, touch and gestures, can help
mobility problems – many people become less able to move about unaided. Some may eventually become unable to walk and require a wheelchair or be confined to bed
behavioural problems – a significant number of people will develop what are known as "behavioural and psychological symptoms of dementia". These may include increased agitation, depressive symptoms, anxiety, wandering, aggression, or sometimes hallucinations
bladder incontinence is common in the later stages of dementia, and some people will also experience bowel incontinence
appetite and weight loss problems are both common in advanced dementia. Many people have trouble eating or swallowing, and this can lead to choking, chest infections and other problems.

How to get a dementia diagnosis

If you're worried about your memory, or think you may have dementia, it's a good idea to see a GP.

If you're worried about someone else's memory problems, encourage them to make an appointment with a GP and perhaps suggest that you go with them.

Getting a diagnosis gives you and your family the best chance to prepare for the future.

With treatment and support from healthcare professionals, family, and friends, many people are able to lead active, fulfilling lives with dementia.

What to expect when you see a GP about dementia

A GP will ask about your symptoms and other aspects of your health.

They'll also ask if you're finding it difficult to manage everyday activities such as:

washing and dressing (personal care)
cooking and shopping
paying bills

If possible, someone who knows you well should be with you at your GP appointment, so they can describe any changes or problems they've noticed. They could also help you remember what was said at the appointment, if this is difficult for you.

Memory problems do not necessarily mean you have dementia. These problems can have other causes, such as:

depression and anxiety
sudden confusion (delirium) caused by a medical condition, such as an infection
an underactive thyroid (hypothyroidism)
side effects of some medicines

To help rule out other causes of memory problems, the GP will do a physical examination and may organise tests, such as a blood test and urine test.

You'll also be asked to do a memory or cognitive test to check any problems with your memory or ability to think clearly.

Read more about the tests used to diagnose dementia.

Referral to a dementia specialist

Dementia can be difficult to diagnose, especially if your symptoms are mild.

If the GP has been able to rule out other causes for your symptoms, they may refer you to a healthcare professional who specialises in diagnosing dementia, such as:

a psychiatrist with experience of treating dementia (an old-age psychiatrist)
a doctor specialising in elderly care (a geriatrician)
a doctor specialising in the brain and nervous system (a neurologist)

The specialist may work in a memory clinic with other professionals who are experts in diagnosing, caring for, and advising people with dementia, and their families.

At your appointment with the specialist

It's important to make good use of your time with the specialist. Write down questions you want to ask, make a note of any medical terms the doctor uses, and ask if you can come back if you think of more questions later. Taking the opportunity to go back can be very helpful.

The specialist may organise more tests. One of these might be a brain scan, such as a CT scan, or an MRI scan.

They may also do further, more detailed memory tests.

If the specialist is still not certain about the diagnosis, you may need to have further, more complex tests. But most cases of dementia can be diagnosed after these assessments.

If the diagnosis is dementia

Dementia is one of the health conditions that people are most afraid of.

After you've had the necessary tests (or sometimes before the tests), your doctor should ask if you want to know your diagnosis.

They should explain what having dementia might mean for you and give you time to talk about the condition and ask questions.

Unless you decide otherwise, your doctor, or a member of their team, should talk to you and your family or carer about:

the type of dementia you have or, if it's not clear, they should talk to you about being assessed again in the future
the symptoms and how the condition might develop
the treatments you might be offered
the name of a health or social care professional who will co-ordinate the different types of support you need
care and support services in your area, including support groups and voluntary organisations for people with dementia, their families and carers
advocacy services
how dementia will affect your driving or employment, if this applies to you
where you can get financial and legal advice

You should also be given written information about dementia.

Ongoing dementia assessment

After you've been diagnosed with dementia, the GP should arrange to see you from time to time, to check how you're managing.

The memory service where you were assessed may also continue to see you in the early stages.

The GP and the specialist may also jointly prescribe medicines that may help some of the symptoms of dementia. But not everyone will benefit from these medicines.

During a follow-up appointment with a GP, or other healthcare professional, they'll check how the dementia is progressing and if you have any new care needs.

Ongoing appointments are also a chance to talk about your plans for the future, such as Lasting Power of Attorney, to take care of your future welfare or financial needs, or an advance statement about your future care.

Dementia research

If you're diagnosed with dementia, or mild cognitive impairment (MCI), you may be able to help scientists better understand the condition by taking part in research.

Dementia research projects are happening around the world, and some are based in the UK. If you're a carer of someone with dementia, you may also be able to take part in research.

More information

Find dementia information and support services

Tests for diagnosing dementia

There's no single test for dementia. A diagnosis is based on a combination of assessments and tests. These may be done by a GP or a specialist at a memory clinic or hospital.

Taking a history

This is usually done by a GP. If you're referred to a specialist, a more detailed history will be taken.

It helps if someone who knows you well is also with you, as they can help describe any changes or problems they've noticed.

The doctor will:

ask how and when your symptoms started and whether they're affecting your daily life
check whether any existing conditions, such as heart disease, diabetes, depression or stroke, are being properly managed
review any medicines you're taking, including prescribed medicines, those bought over the counter from pharmacies, and any alternative products, such as vitamin supplements

Mental ability tests to diagnose dementia

People with symptoms of dementia are given tests to check their mental abilities, such as memory or thinking.

These tests are known as cognitive assessments, and may be done initially by a GP.

There are several different tests. A common one used by GPs is the General Practitioner Assessment of Cognition (GPCOG).

Although these tests cannot diagnose dementia, they may show there are memory difficulties that need further investigation.

Most tests involve a series of pen-and-paper tests and questions, each of which carries a score.

These tests assess a number of different mental abilities, including:

short- and long-term memory
concentration and attention span
language and communication skills
awareness of time and place (orientation)

It's important to remember that test scores may be influenced by a person's level of education.

For example, someone who cannot read or write very well may have a lower score, but they may not have dementia.

Similarly, someone with a higher level of education may achieve a higher score, but still have dementia.

Blood tests to check for other conditions

Your GP will arrange for blood tests to help exclude other causes of symptoms that can be confused with dementia.

In most cases, these blood tests will check:

liver function
kidney function
thyroid function
HbA1c (to check for diabetes)
vitamin B12 and folate levels

If your doctor thinks you may have an infection, they may also ask you to do a urine test or other investigations.

Dementia brain scans

Brain scans are often used for diagnosing dementia once the simpler tests have ruled out other problems.

Like memory tests, on their own brain scans cannot diagnose dementia, but are used as part of the wider assessment.

Not everyone will need a brain scan, particularly if the tests and assessments show that dementia is a likely diagnosis.

These scans may also be used to check for evidence of other possible problems that could explain a person's symptoms, such as a stroke or a brain tumour.

An MRI scan is recommended to:

help confirm a diagnosis of dementia and the type of disease causing the dementia
provide detailed information about the blood vessel damage that happens in vascular dementia
show shrinkage in specific areas of the brain – for example, the frontal and temporal lobes are mainly affected by shrinkage in frontotemporal dementia, while usually just the temporal lobes are affected in the early stages of Alzheimer's disease

A CT scan can be used to check for signs of stroke or a brain tumour. But it cannot provide detailed information about the structure of the brain.

Even if a brain scan does not show any obvious changes, this does not mean someone does not have dementia.

Other scans and procedures to diagnose dementia

Other types of scan, such as a SPECT scan or a PET scan, may be recommended if the result of your MRI or CT scan is uncertain.

However, most people will not need these types of scans.

Both SPECT and PET scans look at how the brain functions, and can pick up abnormalities with the blood flow in the brain.

If a specialist is worried that epilepsy may be causing the dementia symptoms, an EEG may be taken to record the brain's electrical signals (brain activity), but this is rare.

What to do if you've just been diagnosed with dementia

If you have just been diagnosed with dementia, you may feel numb, scared, and find it difficult to take everything in.

Give yourself time to adjust to what a dementia diagnosis means for you.

You may find it helpful to talk to a counsellor at a memory clinic, if a local clinic offers this type of support.

You can also contact the helpline of a dementia charity, such as:

If you can, share your feelings about the dementia diagnosis with family and friends.

When you feel ready, create an action plan for the future while you're still able to make clear decisions for yourself.

Services and support

Find out what services are available in your area, so you're prepared and able to use this support if you need it.

Services arranged by local authorities vary between areas, but may include home care services, equipment, and adaptations for your home.

Make a will

It's a good idea to make a will if you have not made one already. This ensures that when you die, your money and possessions go to the people you choose.

A person with dementia can still make or change a will, provided they can show that they understand what they're doing and what the effects will be. A solicitor can advise if this is the case.

Read more about making a will on our page about managing legal affairs for someone with dementia.

Put your papers in order

Make sure all your important papers can be found easily. These might include bank and building society statements, mortgage or rental documents, insurance policies, your will, tax and pension details, bills and guarantees.

Consider setting up direct debits or standing orders for your regular bills. This means they'll be paid automatically from your bank account each month.

Find out more about managing money when you have dementia.

Claim benefits

Make sure you're claiming all the benefits you're entitled to.

In particular, check whether:

you're eligible for Personal Independence Payment or Attendance Allowance – find out more on our page about benefits if you're over State Pension age
your carer (if you have one) is eligible for Carer's Allowance

Other benefits you may be eligible for include Income Support, Housing Benefit, Council Tax Reduction and Pension Credit.

Choose someone to have lasting power of attorney

You can make one or more people an "attorney" to manage your affairs, including your money, property, and medical treatment, if it becomes necessary.

You can choose anyone you trust to be your attorney (usually a close friend or family member), but they must be over 18.

Find out more about power of attorney on our page about managing legal affairs for someone with dementia.

Advance care planning

You may want to make plans for your future care, called an "advance statement" and an "advance decision". These let your family and healthcare professionals know your wishes for your care if you become unable to make decisions (lack mental capacity) in the future.

Read more about advance statements and advance decisions on our page about managing legal affairs for someone with dementia.

Driving

The DVLA may contact your hospital consultant or GP for more information. It may also arrange to assess your driving or eyesight, to check you can drive safely.

Take care of your health

It's important to look after your physical and mental health when you have dementia.

To stay healthy:

talk to a GP if you feel you have low mood or depression. This is common in dementia, but there are treatments, such as talking therapies, that may help
eat a healthy, balanced diet
exercise regularly, such as walking every day, gardening, or doing tai chi
ask a GP if you would benefit from having a flu vaccine and pneumococcal vaccine
have regular dental, eyesight and hearing tests

See a GP if you feel unwell. Problems, such as urinary tract infections (UTIs), can make you feel more confused or agitated if they're not treated quickly.

Find out more about living well with dementia.

Create your life story

A "memory book" can be a way to stimulate your memory and reconnect you with your loved ones in the future.

Your memory book could include photographs, notes, and keepsakes from your childhood through to the present day. It can be a physical book or a digital version.

You may also want to create a digital or online playlist of your favourite music.

Dementia books on prescription

Reading Well Books on Prescription offer helpful information for people diagnosed with dementia, and their relatives and carers.

GPs and other healthcare professionals can recommend titles from a wide range of books about dementia.

The books are available for anyone to borrow free of charge from their local library. Some books might be available as e-books or audiobooks.

Dementia symptoms and diagnosis