Diagnosis and Management of Neurocognitive Conditions.

As our population ages, a quiet crisis is unfolding — one that threatens not only our healthcare systems but the fabric of families and communities. Dementia, along with its early-stage counterpart mild cognitive impairment (MCI), is placing an ever-growing strain on health and social services. At BrainHealthClinic, we believe it’s time to act decisively — and collaboratively — to change the trajectory of this crisis.

The Urgent Reality

According to projections, 1.6 million people in the UK will be living with dementia by 2050, with costs soaring to £47 billion (1). This isn't just a future problem — it’s one that’s already burdening our overworked healthcare services, particularly psychiatry-based Memory Assessment Services (MAS). These clinics, which typically serve individuals over 65, often lack the capacity for personalized risk assessments and interventions (4).

Yet, the average age of MAS patients is 79.7 years, with only 6.1% under age 65, missing a significant window for early prevention or intervention (4).

The Good News: Prevention and Early Treatment Are Possible

Recent advancements offer new hope. Disease-modifying treatments (DMTs) are beginning to target the biological causes of Alzheimer’s disease — but they work best in its early stages (1). That makes timely diagnosis more important than ever.

In parallel, mounting evidence suggests that up to 45% of dementia cases worldwide could be prevented or delayed by addressing modifiable risk factors (2). These include well-known factors such as obesity, excessive alcohol use, and physical inactivity, alongside newer ones like sleep quality (2).

The 2023 World Alzheimer Report emphasized that it’s “never too early, never too late” to take action. Even those already living with MCI or dementia could benefit from lifestyle and health interventions that reduce risk or slow progression (3).

The Gap: Services Are Lagging Behind the Science

There’s a clear disconnect between current service models and the evolving science of dementia prevention. Traditional psychiatry-based memory clinics are not equipped for personalised risk reduction, especially in younger, at-risk individuals.

Contrast this with dementia cohort studies, such as the FINGER trial, which included participants aged 60–77 years, or the Amsterdam Dementia Cohort, with an average participant age of 64 , and over half of whom were 65 or younger (5–6) (#ref6). These studies demonstrate that early intervention is both possible and effective, but current NHS services are not reaching this population in time.

The Solution: Brain Health Services (BHS)

To bridge this gap, a new model of care is emerging: Brain Health Services (BHS). These are designed to:

• Assess and monitor risk factors

• Provide individualised, lifestyle-based interventions

• Focus on individuals with subjective cognitive decline (SCD) or very early MCI

• Support younger, at-risk individuals who may not yet qualify for traditional treatment pathways (7–8)(#ref8)

This model represents a shift from reactive care to proactive prevention, but its success will depend on public-private collaboration. The NHS alone cannot meet the growing demand or deliver the highly personalised care that brain health requires.

A Call to Collaborate

To truly transform dementia care, we must move beyond conventional models. Public-private partnerships can unlock:

• Scalable early risk assessment tools

• Access to emerging therapies

• Educational campaigns about lifestyle-based risk reduction

• Investment in younger populations before cognitive decline sets in

At BrainHealthClinic, we support this vision. Our mission is not only to diagnose but to prevent — through innovation, collaboration, and a deep commitment to evidence-based care.

References

1. Alzheimer’s Research UK. Tipping point: the future of dementia. (2023)

2. Livingston, G. et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet 404, 572–628 (2024). doi:10.1016/S0140-6736(24)01296-0

3. Long, S., Benoist, C., Weidner, W. World Alzheimer Report 2023: Reducing dementia risk: never too early, never too late. (London, England, 2023)

4. Royal College of Psychiatrists. National Audit of Dementia Spotlight Audit in Memory Assessment Services national report. (London: Healthcare Quality Improvement Partnership, 2023/24)

5. Kivipelto, M. et al. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER): Study design and progress. Alzheimer’s & Dementia 9, 657–665 (2013). doi:10.1016/j.jalz.2012.09.012

6. Ngandu, T. et al. A 2-year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. The Lancet 385, 2255–2263 (2015). doi:10.1016/S0140-6736(15)60461-5

7. Frisoni, G. B. et al. Dementia prevention in memory clinics: recommendations from the European task force for brain health services. The Lancet Regional Health – Europe 26 (2023). doi:10.1016/j.lanepe.2022.100576

8. Blane, J., et al. Prevalence of dementia risk factors in a memory clinic setting: The Oxford Brain Health Clinic