Dementia

Professor Ayesha taught Bangla literature for forty years and can still recite Rabindranath from memory, whole poems, in the winter sun on the veranda. What she cannot remember is whether her brother has phoned; he died in 2011. She has started leaving the gas on. Last week she put her gold bangles in the rice tin and accused the maid of stealing them. Her daughter Nasrin found them while cooking.

An illustration drawn from common experience. The people are invented; the pattern is not.

Understanding dementia

Dementia is a group of diseases of the brain, Alzheimer’s disease the most common, that gradually damage memory, thinking, behaviour and the ability to manage everyday life. It is not a normal part of ageing, even if it is common in older age. Some problems that look like dementia, such as depression, thyroid disease, vitamin deficiency or the side effects of medicines, are treatable, which is why proper assessment matters.

How common is dementia?

In 2021, 57 million people in the world were living with dementia, WHO estimates, more than 60% of them in low and middle-income countries such as Bangladesh.

The finding worth knowing

The 2024 Lancet Commission on dementia estimated that nearly half of dementia cases, about 45%, could potentially be prevented or delayed by addressing 14 risk factors across life. They include untreated hearing loss, high blood pressure, diabetes, depression, physical inactivity, smoking, social isolation, air pollution and uncorrected vision loss. It is never too early, and rarely too late, to lower risk.

Signs and symptoms of dementia

• Forgetting recent events or repeating the same questions
• Getting lost in familiar places; trouble with money or cooking
• Changes in personality, suspicion, or withdrawal
• Difficulty finding words

Treatment for dementia

A careful assessment confirms the diagnosis and looks for treatable causes. Care then focuses on keeping the person safe, active and connected, managing symptoms such as low mood, sleeplessness and agitation, and supporting the family, who carry most of the care. Some medicines can help certain types of dementia for a time.

What getting better can look like

Dementia cannot yet be cured. Living well with it is still possible. For a family like Nasrin’s, it might mean a calmer house, a routine her mother can follow, the poems in the winter sun every afternoon, and help for Nasrin before she wears herself out.

Common questions about dementia

Is memory loss a normal part of getting old?

Dementia is not a normal part of ageing, even though it is common in older age. Some problems that look like dementia, such as depression, thyroid disease, vitamin deficiency or the side effects of medicines, are treatable. That is why memory or behaviour that has been changing over months deserves a proper assessment.

Can dementia be prevented?

Not always, but risk can be lowered. The 2024 Lancet Commission on dementia estimated that about 45% of dementia cases could potentially be prevented or delayed by addressing 14 risk factors across life, including untreated hearing loss, high blood pressure, diabetes, depression, physical inactivity, smoking, social isolation, air pollution and uncorrected vision loss.

When to see a psychiatrist

If memory or behaviour has been changing over months, an assessment is the right first step. Sudden confusion is different: it may be delirium, and needs urgent care.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

If you or someone else is in immediate danger, call 999 or go to the nearest hospital emergency department.

Sources

• World Health Organization, “Dementia” fact sheet
• Livingston et al., The Lancet, 2024