The syndromes of dementia are challenging and often difficult to diagnose for the clinician when comorbid symptoms manifest. A thorough clinical examination and neuropsychological assessment will help to establish the underlying causes of dementia in elderly patients, and determine the best course of treatment. Pharmacologically, the use of cholinesterase inhibitors are considered to be drugs of choice for cognitive deficits in dementia. These administered alone, or in combination with psychosocial interventions, will be the mainstay of therapy for the foreseeable future until new treatments become established.

The quality of life in patients with dementia is paramount and long-term care of the patient requires continued education and communication with clinicians, primary carers, care staff and family members. Although the neuropathological changes are irreversible in the majority of presenting dementia cases, there is plenty of scope for improving the quality of life for people with dementia [Lawton, 2000]. However, balancing economics with quality of care is an emotive subject. Globally, the burden of care associated with dementia is expected to increase significantly, based on population growth, increased longevity and increasing incidence of disease. In the UK alone, the cost of care for patients with AD alone is estimated to be up to £4 billion per year [Bosenquet, 1998] with two-thirds attributed to residential care and approximately 25% to hospital costs. In the USA, this figure is approximately US$100 billion per year [Schumock, 1998].

Despite a better understanding of the pathobiology of cognitive impairments and clinical features of dementia over recent years, which have aided diagnosis and management of the disease, further work is required to improve screening and decrease the burden of care on healthcare systems, families and carers. Furthermore, more research is needed to elucidate the mechanisms of the disease to enable new drug targets to be developed based on biological models, which may provide novel treatments for the prevention and management of dementia.