Dementia diagnosis has been debated in Parliament for over a decade. Select committees have taken evidence, ministers have made commitments, and patients have told their stories under oath. What emerges is not just a policy story. It is a picture of a system that knows what it needs to do but has not yet built the means to do it.
The scale of the problem
There are an estimated 982,000 people living with dementia in the UK today. That number will cross one million this year and reach 1.4 million by 2040. Prevalence rises steeply with age, from roughly one in 600 at age 60–65 to one in six over 85, and an ageing population means the curve only steepens.
The economic burden is staggering. Dementia costs the UK an estimated £42 billion per year, rising to £90 billion by 2040. Unpaid care accounts for half of that total. The average cost per person ranges from £28,700 for mild dementia to £80,500 for severe. Yet spending on diagnosis and treatment represents just 1.4% of total dementia healthcare costs.
Dementia costs the UK more than cancer and heart disease combined. Yet the NHS spends more on diagnosing and treating those two conditions than the entire dementia diagnosis budget.
A decade in Parliament
Dementia diagnosis is not a new concern for Parliament. The Health and Social Care Committee has returned to it repeatedly, most intensely in 2021 when the post-COVID backlog became impossible to ignore. But the conversation has shifted. What began as questions about awareness and stigma has become a debate about infrastructure and technology.
The Lords debate of February 2024 on the Dementia Commission Report was a turning point. For the first time, ministers acknowledged on record that the diagnostic pathway is not ready for what is coming: new drugs, new biomarkers, and a population that is ageing fast.
The diagnosis bottleneck
England’s national target is for two-thirds of people with dementia to receive a formal diagnosis. As of January 2026, the recorded rate stands at 66.1%, barely at target. That headline figure masks deep structural problems in the pathway itself.
The average wait from GP referral to diagnosis is 13 weeks, with a range of 3 to 34 weeks. Only a quarter of patients are diagnosed within the 6-week target. Sixty per cent of memory services cannot access brain scan images. Just 6% of psychiatry services meet NICE guidelines for the biomarker testing that would be needed to identify patients eligible for new treatments.
“If you are worried about your memory, you will go to your GP practice… It may take a long while to get your diagnosis, but you are referred from primary care, probably to a mental health trust, to see an old-age psychiatrist. At that point, you may be discharged without any post-diagnostic support because it is incredibly patchy through the country.”
— Fiona Carragher, Director of Research, Alzheimer’s Society, Health and Social Care Committee, May 2021
“I had been going to my GP for a number of years because I knew my personality was changing… I continued to go to see my doctor, but nothing was happening. It got to the stage where I went to see the doctor with my wife, and I had a complete and utter meltdown in the surgery. As a result of that, I was referred to a psychiatrist.”
— John, witness with vascular dementia, Health and Social Care Committee, May 2021
COVID made everything worse. Memory clinics closed. Diagnosis rates fell to 61%. The government committed £17 million to recover them, but the recovery has been slow and incomplete. In some local authority areas, more than half of people with dementia remain undiagnosed.
“36% of people with dementia remain undiagnosed, rising to 50% in some local authority areas.”
— Baroness Manzoor, House of Lords, February 2024
New drugs, old infrastructure
In 2024, two disease-modifying Alzheimer’s drugs received regulatory approval from the MHRA: lecanemab (Eisai) and donanemab (Eli Lilly). For the first time, drugs existed that could slow the biological progression of the disease, not just manage symptoms. It was a landmark moment.
Then NICE said no.
In June 2025, NICE published final guidance recommending against routine NHS use of either drug. The cost per quality-adjusted life year exceeded the threshold. Both drugs require fortnightly or monthly hospital infusions, frequent MRI monitoring, and intensive clinical oversight for side effects. The infrastructure to deliver them at scale simply does not exist. Lecanemab and donanemab are available only to those who can afford to pay privately, creating a two-tier system that Parliament has already begun to challenge.
The drugs require an amyloid-positive diagnosis before treatment can begin. But only 6% of psychiatry services currently meet NICE guidelines for the biomarker testing that would confirm amyloid status. The treatment exists. The diagnostic pathway to reach it does not.
“In the event of a new disease-modifying treatment, there will be a considerable increase in demand for a diagnosis… Given the existing system is already under strain, it is unlikely to have the capacity to cope with such an increase in demand.”
— Alzheimer’s Research UK, written evidence to Health and Social Care Committee, September 2021
“Disease-modifying drugs like lecanemab — approved on accelerated pathways in the US and Japan — are very expensive and would use up half the pharmaceutical costs of all 27 countries of Europe.”
— Lord Patel, House of Lords, February 2024
“There are scale-up issues because the drugs require intravenous delivery, meaning a whole workforce scale-up.”
— Lord Markham, Parliamentary Under-Secretary of State for Health, February 2024
The blood test revolution
If the current pathway is a bottleneck, blood biomarkers could be the bypass. A simple blood test that detects Alzheimer’s pathology years before symptoms appear would transform the economics of diagnosis, replacing expensive PET scans and invasive lumbar punctures with something a GP could order.
The most promising candidate is p-tau217, a blood marker that reflects levels of both amyloid and tau proteins in the brain. In February 2026, research published in leading journals showed that a blood test could forecast Alzheimer’s years before memory loss begins. The science is real. The question is deployment.
“Blood biomarkers are central to improving early diagnosis. The NIHR has set up a biomarker challenge. A Swedish blood test is quite promising.”
— Lord Markham, Parliamentary Under-Secretary of State for Health, House of Lords, February 2024
The Alzheimer’s Society is running a £5 million Blood Biomarker Challenge, aiming to bring a validated blood test into NHS clinical practice by 2029. The ADAPT trial launched in September 2025 across 20 NHS centres and is now recruiting. First results from Oxford and Essex are expected by late 2026.
Alongside blood tests, retinal scanning is emerging as a second diagnostic pathway. Opticians could screen for early signs of neurodegeneration during routine eye examinations, reaching millions of people who would never visit a memory clinic.
“Opticians are a potentially vital front line for retinal scans. I have pulled together a panel to understand this more.”
— Lord Markham, Parliamentary Under-Secretary of State for Health, February 2024
The transition from memory clinic to blood test is not just a technology change. It is a care-setting change. Diagnosis moves from secondary care psychiatry to primary care GP surgeries and potentially high-street opticians. For diagnostics companies, this represents a fundamental shift in who the customer is.
The policy arc
The conversation in Parliament has moved through four distinct phases, each reflecting a shift in what ministers and committees see as the primary obstacle.
The shift from phase to phase tracks clearly. Early debate focused on awareness and stigma. Post-COVID, the conversation moved to backlogs and recovery funding. By 2024, it had become a technology and infrastructure question, with ministers publicly acknowledging that the diagnostic pathway is not ready for what is coming.
The people behind the numbers
Behind the statistics are people. Patients diagnosed with dementia, their carers, and clinicians working inside the system have all given evidence to select committees. Their accounts describe a pathway that is fragmented, poorly signposted, and often devastating for the people navigating it.
“I waited and waited… After a number of weeks, we eventually contacted the memory clinic… I completely lost faith and trust in what is considered the conventional care system.”
— John, witness with vascular dementia, Health and Social Care Committee, May 2021
“From the moment of diagnosis through to the moment he went into the home, I can honestly say that there was no signposting for anything. Everything I found for myself and for Atherton, I discovered. I trawled the internet… We live in a rural area and it is 26 miles to the centre that wonderfully provided his care.”
— Deborah Gray, carer (husband Atherton had early onset dementia), Health and Social Care Committee, July 2020
“I did not know there was a day centre seven minutes away from my home, and I had been dealing with this for several years by then. There is no signposting and the whole thing is a quagmire.”
— Deborah Gray, Health and Social Care Committee, July 2020
“Physically fit people in their 40s and 50s and 60s with dementia can be very difficult to cope with for their families… It is traumatic for adult children to watch a parent become unrecognisable in personality, the effect on young children is dreadful.”
— Diana Wynter, personal submission, Health and Social Care Committee, 2018
Early onset dementia, affecting people in their 40s, 50s, and 60s, has been raised repeatedly but never systematically addressed. There has been no dedicated select committee inquiry and no quantified backlog for younger patients. It remains a policy blind spot.
What this means for diagnostics
For any company developing a dementia diagnostic, the policy direction is clear: there is pull.
Ministers have named the problem. They have committed £160 million per year to dementia research. They have acknowledged that the current pathway cannot support new treatments. They have publicly cited blood biomarkers and retinal scanning as promising technologies. And NICE has rejected the first disease-modifying drugs partly because the diagnostic infrastructure to identify eligible patients does not exist.
The gap between approved drugs and deployed diagnostics is not a failure of science. It is a failure of infrastructure. That gap is the market. Any technology that can move diagnosis from a 13-week specialist pathway to a primary care blood draw has a direct line to NHS adoption.
The government has committed to doubling dementia research funding. The Blood Biomarker Challenge is recruiting. The ADAPT trial is running across 20 NHS sites. The direction of travel is not in doubt. For diagnostics companies, the question is not whether the NHS will adopt new diagnostic technology. It is who will be ready when it does.
Related insight NHS market access for diagnostics: where the routes are open and where they’re blocked The NICE evaluation bottleneck that affects dementia diagnostics is part of a wider structural problem across health technology.