Thousands of dementia patients in England are not receiving medications that could help them manage symptoms and maintain independence, according to new data from NHS England. A significant disparity exists in prescription rates across different regions, with some areas offering treatments up to nine times more frequently than others.
Charities have labeled this widespread variation "alarming" and "particularly shocking," given that the drugs are recommended by the National Institute for Health and Care Excellence (NICE) for their proven benefits in improving cognition, daily functioning, and potentially prolonging independence.
NICE recommends four drugs for Alzheimer's disease, mixed dementia, and dementia with Lewy bodies: donepezil, rivastigmine, and galantamine, which are acetylcholinesterase inhibitors (AChEIs), and memantine. Nationally, approximately 25 percent of diagnosed dementia patients received an AChEI in the last year, 23 percent received memantine, and 6.1 percent received both.
However, the prescription rates for AChEIs varied from 11.7 percent in Somerset to 31.1 percent in Lincolnshire. Memantine prescriptions ranged from 9.7 percent in Birmingham and Solihull to 35.4 percent in Gloucestershire. The combined prescription rate for both types of treatment showed the most significant disparity, with 1.2 percent in Somerset compared to 10.5 percent in North East and North Cumbria, meaning a patient in the latter region is nearly nine times more likely to receive combination therapy than one in Somerset.
Michele Dyson, chief executive of Alzheimer's Society, stated that only a quarter of diagnosed dementia patients are receiving recommended treatments, and the regional variations are substantial. "Such widespread variation is alarming," Dyson said. "It is particularly shocking as these are NICE-recommended treatments that we know bring real benefits, helping people manage symptoms and maintain their independence for longer."
While the exact reasons for these discrepancies are not fully understood, the Alzheimer's Society suggests that a lack of investment and prioritization of dementia care may be contributing factors. The organization is calling on the government to ensure everyone receives an accurate diagnosis, a care plan, and appropriate treatment within 18 weeks of referral.
NHS England acknowledged that dementia prescriptions reached a ten-year high last year, with five million medications dispensed. A spokesperson noted that it is not always appropriate or safe for patients to receive AChEI or memantine, and this is determined through medication reviews. The NHS reported that over 300,000 people with dementia received a medication review in the year to March 2026. The health service is developing a new national prescribing guidance tool to help reduce variation and standardize medicine availability across England.
A Department of Health and Social Care spokesperson affirmed the government's commitment to improving outcomes for people with dementia and their caregivers. Initiatives include appointing a dedicated dementia tsar to drive innovation and improvements in care, and accelerating the timetable for social care reform.