Topics of interest · Dementia
Living with dementia: assessment, care and new treatments.
A plain-language guide to why assessment and monitoring matter, how to live well with support, and what the new amyloid-targeting therapies do and do not offer.
A diagnosis of dementia is a beginning, not an ending. Most people live for years after a diagnosis, and how well those years go owes a great deal to good assessment, good support, and clear information.
This page is a plain-language overview for people living with changes in memory and thinking, and for the families who care for them. It explains why a careful assessment is worthwhile, how people live well with the right support, and what the newer amyloid-targeting medicines for early Alzheimer's disease actually do. Our role is neuropsychological assessment, setting a baseline, monitoring change over time, and support, including guidance on recognised, evidence-based non-pharmacological approaches. We do not prescribe these medicines or provide infusions; that sits with specialist medical teams. If you would like a memory assessment, you can read about our dementia and memory assessment.
Why it matters
Why assessment and monitoring matter
Not every change in memory is dementia, and not every dementia is the same. A careful assessment answers a practical question and gives everyone a clearer place to start.
- It helps tell ordinary ageing from a change that needs attention, and mild cognitive impairment from a dementia
- It describes which thinking skills are affected, such as memory, attention, language, visuospatial skills and planning, which helps the treating doctor consider the cause
- It looks for treatable contributors that can look like dementia, such as depression, sleep problems, medication effects, thyroid or other physical illness, so these are not missed
- It sets a baseline, a clear snapshot of thinking today, so that future change can be measured rather than guessed at
- It informs practical questions about everyday function, driving, and the supports a person needs
- Where one of the new medicines is being considered, an objective baseline and monitoring over time help the specialist team judge whether thinking is staying stable or changing
A neuropsychological assessment is one important part of the diagnostic picture. A diagnosis is made by a doctor, who brings together the assessment, the medical history, examination and any scans or blood tests.
Living well
Living well, with support
A great deal can be done to support quality of life, independence and connection after a diagnosis. Much of it does not come from a prescription.
- Information and a plan. Understanding the diagnosis, what to expect, and what to put in place next reduces uncertainty for the whole family
- Staying active and connected. Physical activity, social contact, mentally engaging routines, good sleep, and managing blood pressure, hearing and mood all support brain health and wellbeing
- Practical supports at home. Routines, reminders, and small changes to the home can help a person keep doing what matters to them for longer
- Planning ahead, while it is easy to do. Putting an enduring power of attorney and advance care wishes in place early means a person's own preferences guide decisions later
- Support for carers. Caring is demanding, and carer wellbeing matters in its own right. Respite, counselling and peer support all help
- Knowing where to turn. The National Dementia Helpline (1800 100 500) offers free advice and support, and your GP can connect you with local services and aged-care pathways
We offer psychological support for the adjustment that a diagnosis brings, both for the person diagnosed and for those who care for them. Adjusting to changes in thinking is a normal part of the process, and support helps.
“A clear baseline today is often the most useful result of all.”
New treatments, explained
The new amyloid-targeting therapies
You may have read about lecanemab (Leqembi) and donanemab (Kisunla). These are the first medicines shown to act on the underlying disease process in early Alzheimer's, rather than only easing symptoms. They are a genuine step, and it is just as important to be clear about their limits.
Both are anti-amyloid monoclonal antibodies. They are designed to attach to amyloid, a protein that builds up into plaques in the brain in Alzheimer's disease, and help the body clear it. They are given by a drip into a vein (intravenous infusion) on a regular schedule over many months, in a hospital or specialist clinic.
In Australia, the Therapeutic Goods Administration (TGA) registered donanemab in May 2025 and lecanemab in September 2025, each for early Alzheimer's disease (mild cognitive impairment or mild dementia due to Alzheimer's). At the time of writing they are not funded on the Pharmaceutical Benefits Scheme (PBS). Donanemab was not recommended for PBS listing when the Pharmaceutical Benefits Advisory Committee considered it in 2025, and lecanemab is not PBS-funded, so access is private, with out-of-pocket costs that can run to tens of thousands of dollars. Funding decisions are still evolving, and your specialist can advise on the current position.
Who they are for
Narrow eligibility, and careful checks first
- They are only for people in the early stages of Alzheimer's disease. They are not suitable for moderate or advanced dementia, or for other causes of dementia
- Alzheimer's disease must be confirmed by a biomarker, that is, evidence of amyloid from a PET scan or a sample of spinal fluid, before treatment can begin
- People who carry two copies of the APOE4 gene are generally not suitable, because their risk of side effects is judged too high relative to the benefit
- An MRI scan is needed before starting, and the treatment is not suitable for some people, for example those on blood thinners or with certain findings on the scan
- In practice, only a minority of people with Alzheimer's disease will be eligible. Published Australian commentary suggests fewer than one in ten
Benefits and risks, plainly
A modest slowing, not a cure
These medicines do not stop, reverse or cure Alzheimer's disease. In the major trials they slowed the rate of decline over about 18 months. People taking them still declined, just somewhat more slowly than those who did not. The average benefit was statistically real but small, and experts continue to debate how noticeable it is in day-to-day life.
The main risk is a side effect called ARIA (amyloid-related imaging abnormalities), seen on MRI as swelling or small bleeds in the brain. Often it causes no symptoms and settles, but it can occasionally be serious. Because of this, people on these medicines have regular MRI scans to monitor for ARIA throughout treatment. The risk is higher in people who carry the APOE4 gene.
Because of the checks, the infusions and the monitoring, these treatments are prescribed and supervised by specialist medical teams, not by a neuropsychologist. Whether a particular medicine is right for someone is a decision for that person, their family and their treating specialist.
Where we fit
Our part: assessment, baseline and monitoring
Our role is the same whether or not a person is considering one of these medicines. We provide neuropsychological assessment to describe thinking carefully, a baseline against which future change can be measured, and monitoring over time to see whether thinking is stable or changing. That objective picture is useful information for the specialist team and for the family. We do not prescribe medicines, order or interpret the MRI safety scans, or provide infusions.
What is involved
A calm, unhurried assessment
A typical assessment includes a clinical interview, a testing session, and time for scoring, interpretation and a written report. Plan for a morning or an afternoon, sometimes split across two visits. Where possible, and with consent, we like to speak with a family member or someone who knows the person well, because they often notice changes that are hard to describe yourself. Being rested helps; it is useful to bring glasses and hearing aids if used, a list of medications, and any previous reports or scans.
You receive a written report in plain language that answers the referral question, describes the thinking profile, and sets out practical recommendations. With consent, we share it with the referring doctor or specialist team.
Cost & funding
Clear on cost before we begin
Neuropsychological assessment is not rebated under Medicare's Better Access program. Assessments are commonly funded privately, or through the NDIS, DVA, WorkCover Queensland or insurers. We confirm the funding pathway before booking. See our Fees and Policies page.
Take the next step
If you have noticed changes in memory or thinking, or you are weighing up options after a diagnosis, request an appointment or call 0452 452 262. You do not need a referral for a private appointment. For advice and support at any time, the National Dementia Helpline is 1800 100 500.
Request an appointmentSources: Dementia Australia, Update on dementia treatments and research and Drug approval promising for people with early Alzheimer's (dementia.org.au); National Dementia Helpline 1800 100 500. Therapeutic Goods Administration (TGA), registration decisions for donanemab (Kisunla, May 2025) and lecanemab (Leqembi, September 2025), tga.gov.au. Australian Dementia Network (ADNeT), Another Alzheimer's treatment approval means hope and choice for patients, September 2025. Australian Prescriber, New and emerging drug therapies for Alzheimer disease (effect sizes and ARIA rates; CDR-SOB and iADRS differences below the minimal clinically important difference). van Dyck CH et al., Lecanemab in Early Alzheimer's Disease, N Engl J Med 2023 (CLARITY-AD). Sims JR et al., Donanemab in Early Symptomatic Alzheimer Disease, JAMA 2023 (TRAILBLAZER-ALZ 2). Information current at June 2026; treatment availability and funding are changing. This page is general information, not medical advice.