Dementia remains one of the most pressing public health challenges of our time. It is now a leading cause of death in the UK. According to Alzheimer’s Research UK, 1 in 2 people will be impacted by dementia during their lifetime, and 1 in 14 people over the age of 65 currently live with the condition in the UK. These are sobering figures.
For those working in casualty claims, dementia frequently arises – whether in assessing the “but for” scenario of an injured claimant with pre-existing dementia, or in considering a post-accident dementia diagnosis. Each case requires careful analysis of causation, treatment options, and medical context.
The current landscape of Alzheimer’s research
Research into dementia is accelerating, with much of the focus on Alzheimer’s disease, which accounts for 60–70% of all dementia cases (WHO). Globally in 2025, there are 1,833 trials and 138 novel drugs being tested (Cummings 2025).
While headlines have long spoken of “breakthroughs,” the reality in the UK remains limited. Treatments are available, but they are not cures, and NHS care still focuses largely on symptom management.
A recent Times article (1) cautions against overhyping new drugs. Robert Howard, Professor of Old Age Psychiatry at UCL, stresses the importance of managing expectations – while hope for new drugs exists, many patients continue to face limited options today.
Developments in Alzheimer’s treatments
Amyloid-targeting drugs (such as Lecanemab and Donanemab) have shown the ability to slow progression in early-stage Alzheimer’s by 4–6 months. However, they come with challenges:
- Costs: Tens of thousands of pounds per patient.
- Risks: Side effects including brain swelling and bleeding, affecting up to 24% of patients taking Donanemab.
- Accessibility: Until recently, treatments required infusion in a clinical setting.
Regulatory approvals
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Aducanumab (Aduhelm®) received accelerated FDA approval in 2021 but was later discontinued.
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Lecanemab (Leqembi®) gained FDA approval in 2023.
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Donanemab (Kisunla™) followed in 2024.
- Both were approved by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) but in June 2025 NICE declined to recommend them for NHS use, citing limited benefit compared with cost. They remain available privately.
Recent FDA approvals worth noting
- May 2025: FDA approved the first Alzheimer’s blood test (Lumipulse G pTau217/ß-Amyloid 1-42 Plasma Ratio), enabling earlier detection of amyloid plaques.
- August 2025: FDA approved Leqembi® IQKLIK™, a subcutaneous injection for home use – potentially a step toward greater accessibility.
What’s on the horizon?
- Diagnostic Innovation: AI-driven tools such as CognoSpeak (University of Sheffield) and the Fastball test (Universities of Bath & Bristol) aim to speed up diagnosis.
- New Drugs:
- Hydromethylthionine mesylate (HMTM), developed by UK-based TauRX, targets tau proteins and has shown promise in Phase 3 trials.
- Repurposed drugs, such as Semaglutide (Ozempic/Wegovy), are being trialled for potential benefits in memory and cognition.
Implications for casualty claims
For casualty practitioners, these developments raise important considerations:
- Awareness: New diagnostics and treatments may be cited by claimant teams in cases involving dementia (e.g., post-traumatic brain injury or pre-existing conditions).
- Caution: While some drugs are available privately, their risks, costs, and limited effectiveness mean they will rarely be clinically appropriate or justifiable.
- Expert Evidence: Careful medical input remains essential when evaluating claims involving dementia.
- Future Outlook: While a cure is not yet in sight, advances in diagnostics and emerging therapies hold promise for more effective management in the years ahead.
Despite significant global investment, the UK has yet to experience a true breakthrough in Alzheimer’s treatment. Current drugs provide modest benefits at high cost, with safety concerns limiting their appeal. Yet innovation in diagnostics and novel therapies offers cautious optimism for the future.
For those handling casualty claims, staying informed about these developments is vital. While the practical impact on current cases is limited, the landscape is evolving rapidly – and with it, the potential implications for claim strategy and outcomes.