By Lord Darzi of Denham

Copyright newstatesman

We stand at the threshold of a new era in the battle against dementia.

For the first time, a wave of scientific breakthroughs is offering more than just hope; it is delivering tangible tools to alter the course of this devastating condition.

Although not approved by NICE in 2024, the Medicines and Healthcare products Regulatory Agency (MHRA) approved the first generation of disease-modifying treatments for Alzheimer’s as safe and effective, heralding a pivotal shift from managing symptoms to targeting the underlying pathology.

Yet, as I argued in my independent investigation of the NHS, and more recently in a white paper for the Future State Programme, the true challenge lies not in invention, but in integration.

If we are to translate these scientific victories into meaningful change for the one million people living with dementia in the UK today, we must radically innovate how our health and care systems operate.

The recent licensure of lecanemab and donanemab in the UK marks a watershed moment. These therapies, which target the amyloid plaques associated with Alzheimer’s, represent the frontline of a pharmaceutical revolution, with over 138 novel drugs currently in clinical trials. However, their effectiveness hinges on early and accurate diagnosis – a domain where we continue to fall short.

While the NHS has made strides, the national dementia diagnosis rate stood at 65.4 per cent in early 2025, just shy of the 66.7 per cent target that has now been retired from official guidance. This means over a third of people with dementia remain undiagnosed, locked out from the very innovations that could preserve their cognitive health and independence for longer.

This diagnostic gap is where technological innovation offers the most immediate promise.

The UK Dementia Research Institute’s (UK DRI) Care Research and Technology Centre, in collaboration with the Helix Centre at Imperial College London, is pioneering the use of in-home sensors and digital biomarkers.

By monitoring daily routines, sleep patterns, and vital signs, their ‘Minder’ platform can detect subtle cognitive changes that may signal the onset of dementia long before overt symptoms appear. This approach not only facilitates earlier intervention but also provides the rich, real-world data needed to personalise care.

We must look to nations like Sweden, which often tops European dementia care rankings, and learn from their success in creating integrated, technology-enabled care pathways. Their model demonstrates that high diagnosis rates and effective care are not mutually exclusive but are, in fact, deeply interconnected.

The economic imperative for this shift is undeniable. By 2040, dementia is projected to cost the UK economy £90bn annually. The advent of new treatments, while welcome, will place further strain on NHS resources unless we build a system ready to deliver them efficiently and equitably. This requires a concerted effort to break down the silos between health and social care, between primary and secondary services, and between research and clinical practice.

The government’s Modern Service Framework for Dementia and Frailty, informed by the Casey Commission, will provide the strategic blueprint for this integration. It is a critical opportunity to embed innovation at every stage of the dementia journey – from early detection using digital and blood biomarkers to personalised in-home support and streamlined access to clinical trials.

By bringing together the expertise of organisations like Alzheimer’s Society, the UK DRI, and pioneering research hubs like the Helix Centre, we can design a system that is not merely reactive but proactive, predictive, and patient-centred.

The science has delivered breakthroughs; now, through bold policy and a relentless commitment to integration, we must ensure they reach every person who stands to benefit. The time for incremental change is over. The future of dementia care is here, and we must have the courage to build it.

These new drugs represent a monumental leap forward, shifting our focus from merely managing cognitive decline to actively intervening in the disease process by clearing the toxic amyloid proteins that accumulate in the brain. However, this progress is a double-edged sword. It heightens the urgency of our diagnostic mission, as these treatments are most effective in the earliest stages of the disease.

The recent decision to retire the 66.7 per cent diagnosis rate target from the 2025/26 NHS planning guidance, while perhaps pragmatic from a systems perspective, sends a worrying signal.

The move risks normalising a reality where hundreds of thousands of citizens are left in the dark, unable to access treatments, plan for their future, or participate in the very clinical trials that drive further progress. For families, a timely diagnosis is not a statistic; it is the key that unlocks support, reduces uncertainty, and allows for precious time to be spent with loved ones in a structured, supported way.

The work of the Helix Centre and the UK DRI is not science fiction; it is the blueprint for a new standard of care. Other projects like the Longitude Prize on Dementia are further accelerating this by incentivising the creation of bespoke technologies, co-designed with people living with the condition.

Finalists are developing everything from AI-powered communication aids that support independent living to automated fall detection systems that enhance safety.

This is the democratisation of healthcare in action. Yet, to scale these innovations, we must learn from international exemplars.

Countries like Sweden have not only achieved higher diagnosis rates but have also built the integrated infrastructure to support people post-diagnosis.

They have invested in national dementia registries, standardised care pathways, and robust social support systems that wrap around the individual and their family. Their success is not a matter of higher spending alone, but of smarter, more integrated system design that prioritises early detection and continuous, person-centred care.

Building this integrated system is the central challenge of our time. It requires more than just new technology; it demands a new mindset.

We must move beyond the outdated and unhelpful division between ‘health’ and ‘social’ care and recognise that for a person with dementia, these are two sides of the same coin.

The government’s forthcoming Modern Service Framework for Dementia and Frailty, which I have been privileged to contribute to, offers a once-in-a-generation opportunity to hardwire this integrated approach into our national policy.

It must be bold, setting clear timelines for the adoption of new diagnostic tools, establishing a clear pathway for the approval and funding of new treatments, and investing in the workforce training needed to deliver this new model of care.

The science has given us the tools to change the story of dementia. Now, we must write a new chapter of integrated, innovative, and compassionate care for all.