Dementia is an umbrella term for several diseases characterised by cognitive decline in at least one cognitive domain which impacts a person’s ability to independently perform complex activities of daily living. Mild cognitive impairment is characterised by cognitive impairment, with minimal impact on activities of daily living. Most people with dementia or mild cognitive impairment are older (aged 65 years or over) and like most older people have multiple chronic conditions and use multiple medicines to manage these conditions. The nature of dementia and mild cognitive impairment means that there are some special considerations around appropriate medicines use and some unique challenges in optimising medicines use for these people. In this chapter, we discuss considerations for appropriate medicine use in people living with mild cognitive impairment and dementia and we provide an overview of the challenges for optimising medicine use in people living with mild cognitive impairment and dementia. In addition, we summarise the evidence from interventions which aim to educate and empower individuals living with mild cognitive impairment and dementia, and their carers, to use their medicines safely and effectively.