People living with undiagnosed dementia are three times more likely to visit A&E

Key facts about dementia

• Dementia costs the UK £42bn a year with almost a million visits to A&E each year by people living with the condition
• With new treatments available but too costly for NHS use, we are calling for earlier diagnosis to make savings
• Earlier diagnosis would lead to fewer people reaching crisis point, meaning savings for the NHS

The impact of dementia on the NHS

This World Alzheimer’s Month, we have published new data revealing that people living with undiagnosed dementia attend A&E three times more than those without the condition, accounting for more than 520,000 visits each year. The study is one of the largest UK studies on the impact of dementia on the NHS. The research was undertaken by CF (Carnall Farrar Ltd) using the records of 26,000 people with dementia, dating back seven years. 

There are currently around one million people living with dementia in the UK but more than a third of people with the condition do not have a diagnosis. The study found that people with undiagnosed dementia, on average, attend A&E one and half times per year which is more than people with mild, moderate and severe dementia, and three times as much as people without dementia but with similar conditions.  

What the research showed about undiagnosed dementia

The research also showed that the more severe the dementia, the longer people stayed in hospital following unplanned admissions. On average, someone with severe dementia will stay four times longer than someone with similar characteristics but who does not have dementia. Hospital admission can cause distress, confusion and delirium for someone with dementia, which can reduce their ability to function and delay their return home.

Increasing number of hospital beds required by people with dementia

By 2025, the number of people with dementia requiring acute hospital beds will reach 20,500 and by 2040 this will increase to 29,400, an increase of 43%. 

We believe the NHS could make significant savings with reduced visits to A&E if more people were diagnosed earlier. 

The call comes after lecanemab – a treatment for Alzheimer’s disease – was approved by the Medicines and Healthcare products Regulatory Agency (MHRA) for use in people with early Alzheimer’s disease, excluding people with two copies of a gene called APOE4. However, in their draft guidance, the National Institute for Health and Care Excellence (NICE) recommended that lecanemab not be provided on the NHS because it is not currently cost effective. 

We are calling on the Government to increase access to early and accurate dementia diagnosis to help families manage symptoms and avoid reaching avoidable crisis point. With a diagnosis people may be able to access interventions such as cognitive stimulation therapy - found to help improve memory and thinking skills – and, for those with Alzheimer’s disease and Lewy body dementia, cholinesterase inhibitors (medication already recommended by NICE) can help them manage their symptoms and stay well for longer. Early diagnosis and existing treatments improve quality of life and are cost effective. 

The need to address the challenge of dementia diagnosis

Kate Lee, Chief Executive Officer for Alzheimer's Society said:  

“Dementia is the biggest health and social care issue of our time and is costing the UK £42 billion per year. Wes Streeting has emphasised the gravity of the issue stating that the NHS is broken and it’s unacceptable that people with undiagnosed dementia are visiting A&E three times more than those without the condition – it’s causing a financial burden for our already struggling healthcare system, which should be a point of focus as we approach the Budget in October.    

"People with dementia often find hospitals confusing and frightening. Prolonged stays in hospital can have a negative impact on their physical health and dementia symptoms can worsen. Early, accurate diagnosis is crucial to manage symptoms and avoid ending up in crisis.

“If we don’t address diagnosis, we have no hope of addressing the other major dementia challenges we face and reducing the cost to the NHS and wider economy, as well as making the most of existing and new treatments which are just on the horizon. The Government must prioritise dementia diagnosis by setting clear and ambitious new targets supported by funded plans so people with dementia get the care and support they so desperately need.” 

Gail Hobson, 43, lives in Durham and cares for her father John Towers, 70, who was diagnosed with Lewy Body dementia (LBD) in May 2023, and said: 

“Dad was always so funny. A proper joker. When I was a teenager sunbathing in the garden, dad would sneak upstairs and pour a jug of freezing cold water out the upstairs bedroom window. He was always full of fun. He loved life, but most of all he loved my mam. Still loves my mam of course, but it's not as easy for him to show it. 
 
In December 2021, dad was diagnosed with a very slight cognitive impairment. He was losing his keys or misplacing his wallet. He lost interest in listening to music and became quite nervous about driving to new places and would almost be fixated on journey times and routes. 

“In May 2022, dad fell backwards in the shower. Mam didn’t see the fall, but it looked like he had just fallen straight back. There was blood all over the bathroom floor and we took dad to A&E. He didn’t require any stitches, and the CT scan performed in A&E was clear.".

Then dad got mixed up at a roundabout that he used every day and went the wrong way around the roundabout. He never drove the car again. 

 

“We went to see the GP and she did a memory test. I thought dad didn’t do well at all and was very worried, but the GP felt he was suffering from anxiety. In that November we took dad back to the GP as we felt he needed something to help with his memory and low mood. The GP referred dad to the Memory Clinic.  

“In February 2023, dad had another collapse. Totally random, dad just suddenly fell backwards onto the pavement. He went to A&E and had a CT scan. The results were clear again with just a normal ageing brain. 

“In March 2023, dad had a diagnostic assessment where the diagnosis was dementia. Looking back the diagnosis experience was horrendous. Nobody mentioned Lewy Body. We were passed from pillar to post. Dad had every scan going - MRIs, CT scans, CT scans with dye and they could not find dementia. Doctors didn’t have an answer because the scans were clear. We did not have the right type of scan to detect dad's dementia type.” 

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