Alzheimer's disease assessment and treatment
An assessment to find out whether memory and thinking problems are due to Alzheimer's disease, and to start the right support and treatment if they are.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Alzheimer's disease is the most common cause of dementia and usually starts with problems remembering recent things.
- There is no cure; approved medicines may ease symptoms for a time in some people but do not stop the disease.
- Diagnosis is built from history, tests, bloods and usually a scan — not from one test — and is not always certain at first.
- An early, accurate diagnosis opens the door to treatment, support and planning while the person can take part in decisions.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your psychiatrist will give you advice for your situation.
Clarifies whether Alzheimer's disease is the cause, and looks for treatable factors too
Sudden confusion over hours or days — this points to delirium from illness or infection and needs urgent medical assessment, not a routine clinic.
You may feel tired or unsettled after testing. A first impression may be shared, but a full answer often follows once blood tests and any scan are back.
A clear, compassionate explanation of the diagnosis and an honest discussion of what treatment can and cannot do.
You may feel tired or unsettled after testing. A first impression may be shared, but a full answer often follows...
Results are reviewed together and the diagnosis is usually given, with a letter to your GP and an agreed plan...
If a cholinesterase inhibitor or memantine is started, the dose is built up slowly and you are reviewed for...
The team and your family look for any change in symptoms, mood and daily living. Support is put in place and...
What is Alzheimer's disease assessment and treatment?
Alzheimer's disease is the most common cause of dementia. It usually begins with problems remembering recent events, and later affects thinking, language, planning and daily living. It is caused by changes in the brain that build up slowly over years.
Assessment means finding out whether Alzheimer's disease is the cause of someone's symptoms. There is no single test for it. A memory clinic team — often led by an old age psychiatrist — builds a picture from your history, an account from someone who knows you well, pen-and-paper tests of memory and thinking, blood tests, and usually a brain scan. Other causes, including treatable ones, are looked for too.
Treatment is honest about what it can and cannot do. There is no cure for Alzheimer's disease, and no treatment that reverses it. Medicines such as donepezil, rivastigmine, galantamine and memantine may help some people's symptoms for a time, and support, planning and treatment of other health problems matter just as much.
The value of assessment is understanding, support, and planning while decisions can still be made — not a promise that the disease can be stopped.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
What treatment can and cannot do
| Reality | |
|---|---|
| Cure the disease | No — there is no cure, and no medicine reverses it |
| Ease symptoms for a time | Sometimes — medicines help some people, often modestly |
| Work for everyone | No — benefit varies, and some people get little or no help |
| Stop progression | No — the disease continues; medicines are reviewed for benefit |
| Support and planning | Always valuable, whatever the medicine does |
Medicines are only one part. Support, treating other health problems, and planning ahead matter at least as much.
Preparing for your test
- Bring someone who knows you well; their account of changes over time is one of the most useful parts of the assessment.
- Note when the problems started and give everyday examples, especially around remembering recent events.
- Bring a full list of your medicines, including anything bought without a prescription.
- Bring glasses and hearing aids and use them during testing, as poor eyesight or hearing can lower scores unfairly.
- Mention low mood, poor sleep, recent illness or bereavement, as these affect memory and may be treatable.
- Write down your questions, and the medical words used, so you can look them up later.
- If a scan is planned, mention any pacemaker, metal implants, or difficulty with enclosed spaces.
What happens
At the assessment, the clinician talks with you and, where possible, the person who came with you, about your memory, thinking, mood, physical health and daily life. This conversation usually matters most.
You will do some pen-and-paper tests of memory and thinking. Most people also have blood tests and a physical check, and a brain scan is often arranged for another day. The team may give a first impression at the visit, but a clear answer can take longer.
If Alzheimer's disease is diagnosed, the clinician will explain what this means and discuss treatment. A cholinesterase inhibitor (donepezil, rivastigmine or galantamine) may be offered for mild to moderate disease, or memantine for moderate-to-severe disease or where the others are not suitable. Medicines are started at a low dose and built up, and reviewed for benefit and side effects.
Just as importantly, the team should arrange support, discuss planning ahead, and treat other health problems that can make thinking worse.
Is this test right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Sudden confusion over hours or days — this points to delirium from illness or infection and needs urgent medical assessment, not a routine clinic.
- Someone acutely unwell or in pain — treat the illness first, then reassess memory once they are stable.
- Where untreated depression, alcohol use or a medication side effect is the likely cause and should be addressed first.
- Starting a cholinesterase inhibitor where the heart rhythm is too slow or other heart problems make it unsafe.
Delay or rearrange if…
- There is a current infection, delirium or recent hospital stay affecting thinking.
- The person is in crisis or too distressed to take part in testing.
- Key information is missing — no collateral history, or an incomplete medication list.
- Severe untreated low mood, poor sleep or alcohol use may be skewing the picture.
- A heart-rate or heart-rhythm problem needs checking before a cholinesterase inhibitor is started.
Alternatives to discuss
- A GP review first, to treat reversible causes such as thyroid problems, vitamin shortage or low mood.
- Memantine instead of a cholinesterase inhibitor where the latter is not suitable.
- Support, cognitive stimulation and planning without medicine, if medicine is not wanted or not tolerated.
- Watchful waiting with planned review if symptoms are mild or the diagnosis is uncertain.
- The NHS pathway rather than private assessment if speed is not the main concern.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Clarifies whether Alzheimer's disease is the cause, and looks for treatable factors too
- Allows approved medicines to be tried, which may ease symptoms for a time in some people
- Opens access to support, information and benefits for the person and their family
- Lets the person plan ahead — including legal and financial matters — while they can take part
- Helps families understand the condition and what to expect
- Identifies other health problems that, if treated, can improve thinking and wellbeing
Risks & complications
- Finding the tests tiring or upsetting, and worry while waiting for results
- Distress on hearing the diagnosis
- Side effects from medicines, such as nausea, poor appetite, diarrhoea, or a slow pulse with cholinesterase inhibitors
- Medicine that helps little or not at all in some people
- An unclear diagnosis at first, needing further tests or a later review
- Effects on driving, work and insurance that need to be thought through
- A medicine needing to be stopped or changed because of side effects
- Family disagreement about the diagnosis or about care
- A wrong or incomplete first diagnosis that is later revised
- A serious medicine reaction (for example a very slow heartbeat or fainting) needing urgent review
Be clear-eyed about treatment: medicines for Alzheimer's may help symptoms modestly and for a time in some people, but they do not cure or stop the disease, and benefit should be reviewed honestly. A sudden worsening of confusion is more likely to be delirium from illness or infection than the dementia itself, and needs urgent medical attention.
Published figures to discuss
There is no reliable single figure for how well Alzheimer's medicines work, because benefit varies a lot between people and is often modest and temporary. The assessment itself is not a procedure with complication rates; its main uncertainties are diagnostic. We have not quoted percentages here because robust, source-defensible rates for an individual's response or for medicine side effects are not meaningful to state as fixed numbers.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Diagnosis uncertain after first assessment | Common | Depression, delirium, medicines, sleep, alcohol, thyroid/B12 problems and other dementias can mimic Alzheimer's disease. | Guide sourcesClinical context |
| Cholinesterase inhibitor side effects | Common enough to monitor | Nausea, diarrhoea, vivid dreams, dizziness, slow pulse and weight loss can occur with donepezil/rivastigmine/galantamine. | Guide sourcesClinical context |
| Medication benefit misunderstood | Common consent issue | Current symptomatic medicines may modestly support cognition/function but do not cure Alzheimer's disease. | Guide sourcesClinical context |
| Safety and future planning delayed | Avoidable | Driving, falls, medicines, finances, lasting power of attorney and carer support should be addressed early. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery from the assessment. What matters afterwards is understanding the diagnosis, weighing up treatment, getting support, and planning ahead — at a pace that suits you.
- Feeling tired or low for a day or two after a long assessment
- Needing time, and more than one conversation, to take in the diagnosis
- Mild stomach upset or reduced appetite in the first weeks of a new medicine, which often settles
- Only a modest change, or no clear change, from medicines
- Mixed emotions in the person and the family — all of which are understandable
Aftercare
- Make sure you understand the diagnosis and the plan; ask for it in writing if that helps.
- Take any medicine as directed, build the dose up as advised, and report side effects rather than stopping suddenly.
- Keep review appointments so the benefit of treatment can be checked honestly.
- Treat other health problems — blood pressure, hearing, eyesight, mood, sleep — as these affect thinking.
- Look into support early, such as an Admiral Nurse or a local dementia adviser, for the person and family.
- Plan ahead while decisions can be made: lasting power of attorney, finances and future wishes.
- Tell the driving authority — the DVLA if you live in England, Scotland or Wales, or the DVA if you live in Northern Ireland — and your insurer if you are advised this affects driving. This is a legal duty.
- Bring a relative or close friend to appointments
- Full list of current medicines
- Notes on symptoms and daily-life examples
- Glasses and hearing aids
- Questions written down in advance
- A way to record what you are told
- Information about support services to look into afterwards
⚠ Get urgent help if…
- Sudden confusion or a clear change over hours or days — this may be delirium from infection or illness and needs urgent medical help
- Fainting, a very slow pulse, chest pain or collapse after starting a cholinesterase inhibitor — seek urgent medical advice
- Sudden weakness, facial drooping, slurred speech or loss of vision — call 999, as this could be a stroke
- Thoughts of harming yourself, or feeling unable to go on — contact your GP urgently or call Samaritans on 116 123; call 999 if there is immediate danger
- Severe distress, agitation or fear that cannot be settled
- Not eating or drinking, or rapid weight loss
- Becoming unsafe alone — for example wandering, getting lost or leaving the gas on
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your psychiatrist gives you.
Results & realistic expectations
A good outcome from assessment is a clear, honest explanation and a plan: whether this is Alzheimer's disease, whether anything treatable is contributing, and what support and treatment can help. With treatment, a 'good' result is usually a modest, time-limited easing of symptoms in some people — not a cure or a halt to the disease.
It is important to know the limits. The assessment cannot predict exactly how things will change, and medicines do not work for everyone. Benefit is judged over time and reviewed, and a medicine that is not helping may be stopped.
Alzheimer's disease is progressive, so symptoms change over time and the plan is reviewed rather than fixed. Medicines may help for a period and are then reviewed for continued benefit. As the condition advances, the focus shifts towards comfort, dignity, support and planning, with care tailored to the person's needs.
Related tests, treatments or support
Assessment for Alzheimer's is often combined with checking and treating other health problems — blood pressure, heart rhythm, hearing, eyesight, mood and sleep — because these affect thinking and wellbeing. A mood assessment is common, as depression can both mimic and accompany dementia.
Follow-up & long-term care
After diagnosis, a letter usually goes to your GP and the clinic agrees who will follow you up and how often. If a medicine is started, you are reviewed for benefit and side effects, and the dose is adjusted as needed. You should be told who to contact between appointments and how to get support.
- Regular review of symptoms, mood, safety and daily living
- Review of dementia medicines for continued benefit and side effects
- Keeping other conditions well controlled — blood pressure, diabetes, hearing, eyesight
- Ongoing support for the person and family, adjusted as needs change
- Revisiting plans for care, finances and future wishes over time
Repeat, follow-on and what comes next
- The diagnosis may be revised once scans and blood results are back, or as symptoms change over time.
- An uncertain assessment is often repeated after several months, because change over time clarifies the picture.
- Medicines are reviewed and may be increased, switched, added to (for example memantine alongside a cholinesterase inhibitor) or stopped depending on benefit and side effects.
- If a cholinesterase inhibitor is not tolerated, the plan may change to memantine or to non-drug support.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear, compassionate explanation of the diagnosis and an honest discussion of what treatment can and cannot do.
- A named point of contact and a way to ask questions between appointments.
- Planned review of any medicine for benefit and side effects, with a willingness to stop it if it is not helping.
- Signposting to support for the person and family, such as Admiral Nurses or a local dementia adviser.
- Support with planning ahead and honest, kind advice on driving and legal matters.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Length and number of appointments, and whether a consultant old age psychiatrist leads the assessment
- The cognitive tests used and any detailed psychological testing
- Blood tests and physical investigations
- Whether a brain scan (CT or MRI) is arranged, and who reports it
- Whether specialist scans or spinal fluid testing are needed in less clear cases
- Follow-up appointments, medication review, and reports or letters
- The consultant or clinician's fee for assessment and follow-up
- Cognitive testing and any psychology input
- Blood tests and who arranges and interprets them
- Any scan fee and the reporting fee
- Medication review and ongoing prescribing arrangements
- Reports, letters and communication with your GP
- What happens, and what it costs, if the diagnosis is unclear or treatment needs changing
On the NHS? Assessment for Alzheimer's disease and the approved medicines are available on the NHS when clinically indicated; private routes are mostly used for speed, choice or a second opinion.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being led to expect that medicines stop or reverse the disease, rather than easing symptoms for a time in some people.
- A diagnosis from a brief test alone, without bloods, a scan or a collateral history.
- No honest plan for reviewing whether a medicine is actually helping.
- Not being told what the diagnosis means for driving, work and insurance, or who sees the report.
- No discussion of support and planning alongside any medicine.
Marketing red flags
- Claims that a treatment can cure, reverse or stop Alzheimer's disease.
- A 'same-day Alzheimer's diagnosis' or a single test sold as proof of the disease.
- Supplements, infusions or unproven treatments promoted as slowing dementia.
- Pressure to start or pay for treatment without an honest discussion of likely benefit and review.
Choosing a specialist safely
- Check the psychiatrist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good psychiatrist will welcome every one of these.
- How confident are you that this is Alzheimer's disease rather than another cause?
- Have treatable factors — thyroid, vitamins, mood, medicines — been checked?
- What can the medicine realistically do for me, and how and when will we know if it is helping?
- What side effects should I watch for, and when should I seek help?
- What support is available for me and my family, and who do I contact?
- What does this mean for driving, work and planning ahead?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the psychiatrist who carries out my test, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this test not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is there a cure for Alzheimer's disease?
Do the medicines work for everyone?
Can I get the assessment and medicines on the NHS?
How is Alzheimer's told apart from other types of dementia?
Why does an early diagnosis matter if there is no cure?
Will this affect my driving?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — How to get a dementia diagnosis NICE NG97 — Dementia: assessment, management and support NICE TA217 — Medicines for Alzheimer's disease Alzheimer's Society — Medication for dementia symptoms Royal College of Psychiatrists — Memory problems and dementia Dementia UK — How is dementia diagnosed? DVLA — Assessing fitness to drive DVA Northern Ireland — Telling DVA about a medical condition
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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