Rethinking dementia: New book argues attention — not memory — may be the earliest warning sign

A pioneering new book led by a Swansea University academic is offering a fresh perspective on dementia by challenging one of the most familiar assumptions about the condition: that memory loss is always the earliest and most defining symptom.

A New Approach to Dementia: Examining Attention Impairment, authored by Professor Andrea Tales from the School of Health and Social Care alongside colleagues and former students, is one of the first books to place attention impairments—rather than memory dysfunction—at the centre of understanding the syndrome.

Drawing on a growing body of research, the authors highlight that changes in attention are common across different forms of dementia and can appear even earlier than memory problems. They argue that recognising these changes could support earlier identification, more accurate diagnosis, and improved care for those affected.

Professor Tales, Personal Chair in Neuropsychology and Dementia Research, said, "Working with current and former students has been a privilege and always an enjoyable experience. This book builds on our first volume, which explored sensory and perceptual changes and was co-produced with people living with dementia and their caregivers. I'm proud that our collaborative approach continues to grow, helping us shine a light on aspects of dementia that are too often overlooked."

The book spans foundational theory, clinical practice, and lived experience. It examines how attention and executive function interact, how automatic and controlled processes shift in dementia, and why current diagnostic pathways—which rely heavily on memory testing—often miss early attentional symptoms.

The authors also explore the challenge of defining "attention" itself, drawing on classic ideas, everyday language, and modern cognitive science.

A chapter written from a carer's perspective brings these concepts into everyday life, while another introduces attention restoration theory and the potential for natural environments to reduce attentional overload.

As well as its scientific contribution, the book is a distinctive example of academic collaboration. Conceived by Professor Tales, it brings together colleagues and former Ph.D. students and postdoctoral researchers who continue to work closely after completing their studies at Swansea.

The group has committed to producing a series of books designed to advance the field while also giving early-career researchers valuable experience in publishing beyond journal articles and communicating research to wider audiences. A third volume, focusing on technology and dementia, is already in development.

Co-author Dr. Clive Thomas, Programme Manager for the Strategic Programme for Mental Health at NHS Wales Performance and Improvement, said, "Working with Professor Andrea Tales from my professional doctorate onwards has been invaluable. Her understanding of the tensions between clinical practice and academic enquiry helped me see why conventional, memory‑focused assessment services need to evolve.

"Our collaboration has continued over many years, driven by a shared belief in the need for system change and in exploring under‑examined aspects of dementia. I'm grateful to contribute to this book series and to ongoing work with Andrea and the Swansea University team."

Published by Taylor & Francis, the book is available now.

More information:
Founded in 1920, Swansea University is a research-led institution with two campuses along Swansea Bay in south Wales, UK. Its scenic beachfront location and welcoming atmosphere attract more than 23,000 students from around the world. The University offers undergraduate and postgraduate programmes across three academic faculties.
In 2025, Swansea achieved its highest-ever ranking in the QS World University Rankings 2026, reaching 292nd globally and was ranked 29th in the Guardian University Guide 2026.
The 2021 Research Excellence Framework rated 86% of Swansea's research and 91% of its research environment as world-leading or internationally excellent, with 86% of its research impact recognised as outstanding.
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For more information, please contact Ffion White at Swansea University Press Office. Email F.E.White@Swansea.ac.uk or call 01792 602706.

Provided by Swansea University