Why Are Hundreds of Thousands Living with Undiagnosed Dementia?

In 2014, when the Prime Minister launched the Dementia Challenge, the diagnosis rate stood at 58.6%. A major push through GP incentive schemes and memory clinic expansion drove the rate to a peak of 67.6% by 2017 — briefly exceeding the ambition standard of 66.7%.^[1] It has fallen every year since. The COVID-19 pandemic accelerated a decline that was already underway: face-to-face GP consultations collapsed, memory clinic referrals dropped by over 40% in the first lockdown, and many older people with early cognitive symptoms never presented. By 2025, the rate has slipped to 61.4%, meaning more than one in three people estimated to have dementia have no formal diagnosis on their GP record.^[1,2]

The consequences of non-diagnosis are concrete and serious. Without a diagnosis, people cannot access dementia-specific medications such as cholinesterase inhibitors, which can slow symptom progression in early-stage Alzheimer's disease. They cannot be referred to post-diagnostic support services — Admiral Nurses, cognitive stimulation therapy groups, or social prescribing. They are far less likely to set up lasting powers of attorney, make advance care plans, or have conversations with their families about the future while they still can. Memory clinic waiting times, which surged to a median of 13.2 weeks during the pandemic, have recovered to 8.2 weeks but remain double the 4.2-week median seen in 2015.^[3]