This guideline covers diagnosing and managing dementia (including Alzheimer’s disease). It aims to improve care by making recommendations on training staff and helping carers to support people living with dementia.

NICE has also produced a guideline on mid-life approaches to delay or prevent the onset of dementia.

Valproate: In September 2024, the Medicines and Healthcare products Regulatory Agency (MHRA) published a Drug Safety Update on valproate use in men and their partners. Effective contraception (condoms, plus contraception used by the female sexual partner) is recommended throughout the valproate treatment period and for 3 months after stopping valproate, to allow for one completed sperm cycle not exposed to valproate. See the MHRA’s advice for healthcare professionals. NICE is assessing the impact of this alert on recommendations in this guideline.

Valproate: In January 2024, the MHRA published a Drug Safety Update on the risks associated with valproate in men and women under 55. See the MHRA’s advice for healthcare professionals to provide to patients currently taking valproate. NICE is assessing the impact of this alert on recommendations in this guideline.

Last reviewed: 26 September 2023

This guideline is an update of the NICE guideline on dementia (CG42, published November 2006) and replaces it. It also replaces recommendation 1.3 in the NICE technology appraisal guidance on donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease (TA217). It also updates and replaces NICE evidence summary ESUOM40.

We have checked the evidence and propose not to update the guideline. However, because this topic is important to our stakeholders, we will refer it to our new topic prioritisation board for consideration. For more information, see the surveillance decision.

Recommendations

This guideline includes recommendations on:

Who is it for?

  • Healthcare and social care professionals caring for and supporting people living with dementia
  • Commissioners and providers of dementia health and social care services
  • Housing associations, private and voluntary organisations contracted by the NHS or social services to provide care for people living with dementia
  • People living with dementia, their families and carers

Guideline development process

How we develop NICE guidelines

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.