It’s a moment many of us fear: a parent, grandparent, or beloved elder starts to forget things. They might misplace their keys, forget a familiar name, or ask the same question again and again. It’s easy to think, “It’s just old age.” But sometimes, these small changes can be the first signs of a more serious condition called dementia.

Understanding what dementia is, what it is not, and how to recognise the signs is the first and most important step for any family. This detailed guide is here to help you understand this complex condition in simple, clear English.

First, What Exactly is Dementia?

Let’s start with the most important point: Dementia is not a single disease.

Think of “dementia” as an umbrella term, like “heart disease.” Just as heart disease can refer to many different problems with the heart, dementia refers to a collection of symptoms caused by different disorders that damage the brain.

These symptoms lead to a decline in a person’s mental abilities (also called cognitive skills) that is serious enough to interfere with their daily life. It affects how they think, remember, communicate, and behave. It is crucial to understand that dementia is not a normal part of getting older. While it’s common to become a little more forgetful with age, the severe mental decline caused by dementia is not.

Dementia vs. Alzheimer’s Disease: What is the Difference?

This is one of the most common points of confusion. The relationship is simple:

• Dementia is the general term for the symptoms of mental decline.
• Alzheimer’s disease is the most common cause of dementia.

So, a person with Alzheimer’s disease has dementia, but not everyone with dementia has Alzheimer’s disease. Alzheimer’s disease accounts for about 60-70% of all dementia cases. Other diseases can also cause dementia.  

The Growing Concern of Dementia in India

Dementia is a significant and growing health challenge in India. As our population ages, more and more families will be touched by this condition.

A Look at the Numbers: According to recent studies, an estimated 8.8 million Indians over the age of 60 are currently living with dementia. That’s about 7.4% of all senior citizens in the country. Experts project that this number will nearly double to 16.9 million by 2036 as life expectancy increases.  

Despite these large numbers, awareness remains low. It is estimated that in India, only 1 in 10 people with dementia ever receive a proper diagnosis or care. This is often because families mistake the symptoms for normal aging or feel a sense of stigma or shame.  

Recognising the Early Signs and Symptoms of Dementia

It’s important to know what to look for, as an early diagnosis can make a huge difference. The signs can be subtle at first and gradually become more obvious. Here are the common warning signs, explained in simple terms.

1. Memory Loss That Affects Daily Life

This is the most well-known symptom. It’s more than just forgetting where you put your keys.

• What’s normal: Forgetting an appointment but remembering it later.
• What’s a concern: Forgetting recently learned information, asking the same question repeatedly, or forgetting important dates and events completely.

2. Difficulty with Familiar Tasks

A person may struggle with tasks they have done their whole life.

• What’s normal: Occasionally needing help to use the settings on a microwave.
• What’s a concern: Forgetting the steps to prepare a simple meal, how to operate a familiar TV remote, or getting confused while getting dressed.

3. Problems with Language and Words

Struggling to communicate can be a key sign.

• What’s normal: Sometimes having trouble finding the right word.
• What’s a concern: Forgetting simple words, using the wrong words (like calling a “watch” a “hand-clock”), or finding it hard to follow or join a conversation.

4. Confusion About Time and Place

Losing track of where they are or what day it is.

• What’s normal: Forgetting what day of the week it is but figuring it out later.
• What’s a concern: Getting lost in a familiar place like their own neighbourhood, not knowing how they got there, or being confused about the season or year.

5. Poor or Decreased Judgment

Making decisions that are out of character.

• What’s normal: Making a bad decision once in a while.
• What’s a concern: Using poor judgment with money, paying less attention to personal hygiene, or dressing inappropriately for the weather (e.g., wearing many layers on a hot day).

6. Changes in Mood and Personality

Unexplained changes in how they feel or act.

• What’s normal: Feeling sad or moody from time to time.
• What’s a concern: Showing rapid mood swings for no reason, or becoming unusually confused, suspicious, fearful, anxious, or withdrawn.

Understanding the Different Types of Dementia

Because dementia is caused by different types of brain damage, there are several forms of the condition. Knowing the type can help in managing the symptoms.

• Alzheimer’s Disease: This is the most common type. It is caused by the buildup of abnormal proteins in the brain, called plaques and tangles, which kill brain cells. It usually starts with short-term memory loss and slowly affects other cognitive abilities.
• Vascular Dementia: This is the second most common type. It happens when there is damage to the blood vessels in the brain, often after a stroke or a series of mini-strokes. Symptoms can appear suddenly and often include problems with planning, reasoning, and concentration more than memory loss.
• Lewy Body Dementia: This is caused by tiny, abnormal protein deposits in the brain called Lewy bodies. People with this type often have memory loss, but also experience movement problems (like stiffness and tremors), sleep disturbances, and visual hallucinations (seeing things that aren’t there).
• Frontotemporal Dementia (FTD): This type involves damage to the front and side parts of the brain. It is a common cause of dementia in younger people (under 65). The first symptoms are usually changes in personality and behaviour, or problems with language, rather than memory loss.

What Causes Dementia? A Look at the Risk Factors

While the exact cause of most dementias is not known, scientists have identified several factors that can increase a person’s risk. It’s helpful to divide these into two groups.

Risk Factors You Cannot Change

• Age: This is the strongest risk factor. The risk of dementia increases significantly after the age of 65.
• Family History: If your parents or siblings have dementia, your risk is higher.
• Genetics: Certain rare genes can directly cause dementia, but these account for a very small number of cases.

Risk Factors You Can Influence

The good news is that research suggests up to 41% of dementia cases could potentially be prevented or delayed by addressing lifestyle factors. These include:  

• High Blood Pressure (Hypertension): Uncontrolled high blood pressure in mid-life is a major risk factor.
• Diabetes: Poorly managed blood sugar can damage blood vessels in the brain.
• Smoking and Excessive Alcohol Use: Smoking damages your circulation, and drinking too much alcohol can directly harm brain cells.
• Physical Inactivity: Regular exercise is good for your heart and your brain. A sedentary lifestyle increases your risk.
• Obesity: Being obese, especially in middle age, is linked to a higher risk of dementia.
• Hearing Loss: Studies show that untreated hearing loss may force the brain to work harder, increasing dementia risk. Using hearing aids seems to reduce this risk.
• Social Isolation: Staying socially active and engaged helps keep your brain healthy.

The Stages of Dementia: What to Expect

Dementia is a progressive condition, meaning it gets worse over time. While every person’s journey is unique, the progression can generally be understood in three stages.

1. Early Stage (Mild)

In this stage, the person can often still live independently.

• What you might see: Mild memory lapses, like forgetting familiar words or where they put things. They might have some trouble with complex tasks like managing money or planning a trip. Family and friends are often the first to notice these changes.

2. Middle Stage (Moderate)

This is usually the longest stage, and the person will need more support.

• What you might see: Memory loss becomes more significant. They may forget personal details like their own address or phone number. Confusion deepens, and they may wander or get lost. Personality changes can become more obvious, such as becoming suspicious or agitated. They will need help with daily activities like dressing and bathing.

3. Late Stage (Severe)

In the final stage, the person becomes completely dependent on others for care.

• What you might see: They lose the ability to communicate, respond to their environment, and eventually, control their movements. They will need 24-hour care for all daily activities, including eating, bathing, and using the toilet. Their physical abilities decline, and they may lose the ability to walk or even swallow.

Why an Early Doctor’s Visit is So Important

If you notice several of the warning signs in a loved one, it is vital to see a doctor. A proper medical assessment is the only way to get an accurate diagnosis.

This is important for two key reasons:

1. To Rule Out Other Conditions: Many other health issues can cause dementia-like symptoms, such as thyroid problems, vitamin deficiencies, or even infections. Many of these conditions are treatable and the symptoms can be reversed.
2. To Plan for the Future: If the diagnosis is dementia, getting it early gives your family time. It allows you to access treatments that can help manage symptoms, find support services, and make important decisions about future care and finances.

Finding Compassionate Care and Support

A dementia diagnosis can be heartbreaking and feel overwhelming, but it is a journey you do not have to walk alone. While there is no cure for most types of dementia, the right care and support can make a world of difference to the quality of life for both the person with dementia and their family.

At Calida Rehab, we provide expert, compassionate, and dignified care for individuals living with dementia. Our specialized programs focus on managing symptoms, preserving cognitive function for as long as possible, and creating a safe and supportive environment. Our team of dedicated professionals works closely with families to develop personalized care plans, offering guidance and support every step of the way.

Frequently Asked Questions (FAQs) About Dementia

1. Is dementia a normal part of getting old?

 No, absolutely not. It is a common myth that severe memory loss is a normal part of aging. While it’s normal to have minor memory lapses as we get older (like forgetting where you put your keys), dementia is a serious medical condition where the decline in mental abilities is severe enough to interfere with a person’s daily life.

2. What is the main difference between Dementia and Alzheimer’s? 

Think of dementia as the umbrella term. Dementia describes a group of symptoms, including memory loss, confusion, and difficulty with thinking. Alzheimer’s disease is a specific disease, and it is the most common cause of dementia. So, a person with Alzheimer’s has dementia, but not everyone with dementia has Alzheimer’s disease.

3. My parent is forgetting small things. Does this mean they have dementia?

 Not necessarily. Occasional forgetfulness, like forgetting a name and remembering it later, is normal for many people. Dementia involves a consistent pattern of multiple symptoms. If the memory loss is combined with other signs, such as difficulty with familiar tasks, confusion about time or place, and changes in personality, it is a cause for concern. If you are worried, the best step is to consult a doctor.

4. Can dementia be cured?

 Currently, there is no cure for most types of progressive dementia, including Alzheimer’s disease. However, an early diagnosis is very important. There are medications and therapies that can help manage the symptoms and, in some cases, temporarily slow down the progression of the disease. The goal of treatment is to improve the quality of life for the person and their family.

5. Can dementia be prevented? 

While some risk factors like age and family history cannot be changed, research shows that a healthy lifestyle can significantly reduce your risk of developing dementia or delay its onset. Key steps include:

• Managing high blood pressure and diabetes.
• Staying physically active with regular exercise.
• Eating a balanced, healthy diet.
• Staying socially engaged and keeping your mind active.
• Avoiding smoking and limiting alcohol consumption.

6. At what age does dementia usually start? 

Dementia most commonly affects people over the age of 65, and the risk increases significantly as a person gets older. However, it is not exclusively a disease of old age. When symptoms begin before the age of 65, it is called young-onset dementia, but this is less common.

7. What should I do if I think a family member has dementia? 

The most important first step is to gently encourage them to see a doctor. A medical professional can conduct a thorough assessment to understand the cause of the symptoms. It’s important to rule out other treatable conditions that can mimic dementia, such as vitamin deficiencies or thyroid problems. An early diagnosis is the key to getting the right support, care, and treatment.

8. How is dementia diagnosed by a doctor? 

There is no single test for dementia. A doctor will typically use several methods to make a diagnosis, including:

• A detailed medical history of the person and their family.
• A physical examination and blood tests to rule out other conditions.
• Cognitive and neuropsychological tests to assess memory, thinking, and problem-solving skills.
• Sometimes, a brain scan (like a CT or MRI) may be used to look for changes in the brain.

9. How long can someone live with dementia? 

The life expectancy for a person with dementia can vary greatly. It depends on many factors, including the type of dementia, the person’s age at diagnosis, and their overall physical health. Some people live for many years after their diagnosis. The focus of care is always on maintaining the best possible quality of life for as long as possible.

10. Is dementia care available in India?

 Yes, dementia care services are available in India, but they are still growing. There are specialized dementia care homes (sometimes called old age homes for dementia patients), day-care centres, and memory clinics, though most are located in major cities. Organizations like the Alzheimer’s and Related Disorders Society of India (ARDSI) have chapters across the country and are an excellent resource for information, support, and connecting with local services.