Dementia

The first thing to understand is that dementia isn’t a single condition itself. It’s a broad term that describes symptoms that are severe enough to interfere with your daily life — like loss of memory, language and problem-solving skills, coordination, and changes in behavior and mood. Dementia is not a natural sign of ageing. Its symptoms are progressive, meaning they get worse over time.

Alzheimer’s disease is the most common type of dementia, but there are other kinds, including:

• Frontotemporal dementia (FTD)
• Lewy body dementia (LBD)
• Mixed dementia
• Vascular dementia

These conditions can also cause dementia-like symptoms:

• Creutzfeldt-Jakob disease
• Huntington’s disease
• Parkinson’s disease
• Traumatic brain injury
• Wernicke-Korsakoff syndrome

Vitamin deficiencies, some infections, metabolic and endocrine disorders and normal pressure hydrocephalus can also cause symptoms that mimic dementia — but they are often reversible with treatment.

Diagnosing Dementia at Cleveland Clinic London

Dementia can be difficult to diagnose. There are many conditions that can lead to dementia, and symptoms are often similar. That’s why it’s crucial to have an expert neurologist evaluate you.

When you meet with us for the first time, your consultant will:

• Ask about your symptoms and how they’re affecting your life
• Review your medical history and any medications you’re taking
• Ask if other family members have a history of dementia or other neurological conditions

It is very helpful to bring a friend or relative to your appointment. They can help you ask questions and take notes.

Testing for dementia

Diagnostic testing is an important part of your evaluation. Tests can help us diagnose the type of dementia you have, and they can also uncover other possible causes for your symptoms.

Your consultant will perform a neurological physical examination, which may include a neuropsychological assessment. This can help us understand your cognitive function. Your consultant may also order additional tests, including:

• Blood tests: These can help rule out other conditions that mimic dementia symptoms and show biomarkers for dementia.
• Brain MRI: This test can show brain atrophy (changes) and blood vessel damage.
• PET scan: PET scans help us check for abnormal brain activity. Specialised scans can show excess amyloid buildup in your brain related to Alzheimer’s and detect loss of brain function earlier than MRI scans.
• Lumbar puncture (spinal tap): This is used to analyze your brain’s protective layer of cerebrospinal fluid and check for biomarkers of dementia.

Based on your evaluation, the type and severity of your symptoms and test results, your consultant can typically diagnose the type of dementia you have. Your consultant will go over their findings with you and help you understand what to expect from treatment going forward.

Most dementias are chronic. This means there is no way to eliminate them completely. Instead, treatment focuses on managing your symptoms with medications, other therapies and lifestyle changes. With early diagnosis and personalised care from expert consultants, it’s possible to manage your condition and help you stay as independent as possible.

If you do have a reversible type of dementia, we will work with you to uncover the cause of your symptoms and treat that condition.

Medications

There are four medications approved in the U.K. to help manage dementia symptoms.

Donepezil, rivastigmine and galantamine raise the levels of acetylcholine in your brain. This chemical helps your brain cells communicate, which can help manage dementia symptoms. Memantine works by blocking the effects of a brain chemical called glutamate.

Your consultant may also recommend medications to treat specific symptoms if they develop. These include:

• Antidepressants
• Antipsychotics
• Antiseizure medications

Disease-modifying therapies

Disease-modifying therapies are medications that can slow the progression of early-stage Alzheimer’s disease, not just treat its symptoms. Two of these medications, donanemab (KINSUNLA^®) and lecanemab (LEQEMBI^®), have been approved for use in the U.K. Your consultant can let you know if a disease-modifying therapy is an option for you.

Other therapies

Your consultant may also recommend rehabilitation therapies to help with some of your symptoms.

• Speech therapy: Helps with speech and comprehension problems (aphasia), trouble speaking due to muscle weakness (dysarthria) and difficulty swallowing (dysphagia)
• Occupational therapy: Helps you stay independent by working on daily living skills like getting dressed, showering, brushing your teeth or tying your shoes
• Physiotherapy: Helps strengthen your muscles, improve how you walk (gait) and support your overall movement and mobility

Lifestyle changes

Along with medications and therapies, other things you can do to help with symptoms include eating healthy foods, exercising regularly and getting enough sleep. It’s also important to engage your brain by doing puzzles or reading. If you can, stay connected socially with family and friends and manage stress.

Paying for Dementia Care at Cleveland Clinic London

The cost of your treatment at Cleveland Clinic London will depend on your individual medical requirements. You may choose to self-pay or use private medical insurance. If you have any questions, please contact us. Our payment specialists are here to guide you through the financial side of your care.

What’s Next?

Living with dementia — or supporting someone who is — can feel overwhelming and often challenging, but you’re not on this journey alone. Whether you’re looking for answers, a diagnosis or ongoing care, our expert consultants are here to guide you every step of the way. At Cleveland Clinic London, we not only provide the latest testing and treatment options. We also offer you understanding, kindness and support, so you can move forward in life with confidence and dignity.