What Is Dementia? 

Dementia is not one disease.
It is a group of conditions where the brain slowly loses its ability to:

• Remember
• Think clearly
• Communicate
• Make decisions
• Manage daily activities

Over time, dementia affects behavior, emotions, mobility, bladder control, and personality.

I often tell families in clinic:

“Dementia is not just memory loss. It slowly changes how a person experiences the world.”

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How Common Is Dementia?

• Around 55 million people worldwide live with dementia
• In India, estimates range from 4–5 million, and rising
• Risk increases sharply after 60 years
• Women are slightly more affected (longer lifespan)

With longer life expectancy, every Indian family will encounter dementia—directly or indirectly.

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Causes of Dementia

Common Causes

• Alzheimer’s disease (most common)
• Vascular dementia (after strokes, uncontrolled BP/diabetes)
• Lewy body dementia
• Frontotemporal dementia
• Parkinson’s disease dementia

Risk Factors

• Age
• Family history
• Diabetes, hypertension
• Smoking, alcohol
• Head injury
• Low cognitive stimulation

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What Happens in the Brain?

Inside the brain:

• Nerve cells slowly degenerate and die
• Connections between brain cells break down
• Brain areas controlling memory, behavior, movement shrink

In Alzheimer’s:

• Abnormal protein deposits (plaques & tangles)
• Signal transmission becomes faulty

This damage is progressive and irreversible, but symptoms can be managed.

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History & Progression: How Dementia Typically Starts

Early signs are often ignored:

• Repeating questions
• Forgetting recent events
• Misplacing things
• Subtle personality change

Families usually say:

“Doctor, earlier we thought it was normal ageing.”

It is not.

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Symptoms of Dementia (Stage-Wise)

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🧠 1. Cognitive Symptoms

• Memory loss (recent more than past)
• Forgetting names, faces
• Difficulty planning or managing money
• Confusion about date, place, time

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🗣️ 2. Speech & Communication

• Word-finding difficulty
• Irrelevant or repetitive talk
• Talking about old memories as if happening now
• Talking to deceased relatives

I have seen patients clearly describe events from 40 years ago, but forget breakfast.

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😟 3. Emotional & Behavioral Symptoms

• Fearfulness
• Suspiciousness
• Irritability
• Crying spells
• Restlessness in evenings (sundowning)

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🚶 4. Physical & Mobility Problems

• Slowed walking
• Poor balance
• Slipping and falls (very common)
• Stiffness, shuffling gait

Why slipping happens:

• Poor judgment
• Visual-spatial problems
• Weak muscles
• Medication side effects

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🛏️ 5. Bedridden Stage Symptoms

• Unable to sit or stand
• Needs help turning in bed
• Loss of speech
• Feeding difficulty
• Total dependence

This is emotionally exhausting for families.

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Common Problems Faced by Dementia Patients

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🚽 Incontinence (Urine & Stool)

• Loss of bladder/bowel control
• Forgetting toilet location
• Embarrassment and agitation

Care tips:

• Fixed toilet schedule
• Adult diapers/potty chairs
• Never scold or shame

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🩹 Pressure Sores (Bed Sores)

Happen due to:

• Prolonged pressure
• Poor nutrition
• Moisture

Prevention:

• Turn every 2 hours
• Air mattress
• Keep skin dry
• Early medical care

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🧠 Irrelevant Talk & Old Memories

• Talking about childhood
• Calling caregiver by parent’s name
• Mixing timelines

Do not correct aggressively.
Instead, enter their reality gently.

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😨 Fearfulness & Panic

Triggered by:

• Darkness
• Shadows
• Mirrors
• Loud voices

Speak slowly. Sit at eye level. Reassure repeatedly.

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Why Change of Environment Makes Dementia Worse

This is extremely important.

Dementia patients rely on:

• Familiar rooms
• Fixed routines
• Known faces

Triggers for Sudden Deterioration:

• Changing house
• Changing room
• Hospital admission
• New caregivers
• Travel

Families often say:

“Doctor, after hospital stay, he completely changed.”

Yes. Environment change can precipitate delirium and worsening dementia.

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How Family Members Can Take Care (Emotionally & Physically)

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❤️ Emotional Care

• Speak calmly
• Repeat reassurance
• Avoid arguments
• Validate feelings, not facts

Say:

“You’re safe. I’m here.”

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🏃 Physical Care

• Safe walking space
• Remove loose rugs
• Bathroom handrails
• Night lights
• Regular physiotherapy

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🧑‍⚕️ Caregiver Self-Care

This is often ignored.

Caregivers experience:

• Burnout
• Depression
• Guilt
• Sleep deprivation

Taking help is not failure.

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Role of Doctor & Psychiatrist

Psychiatrist Helps With:

• Diagnosis
• Behavioral symptoms
• Anxiety, fear, aggression
• Sleep disturbance
• Caregiver counselling

Investigations Usually Done:

• Blood tests (B12, thyroid, infection)
• Brain imaging (CT/MRI)
• Cognitive testing

Medications do not cure, but:

• Slow progression
• Improve quality of life
• Reduce distress

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Prognosis (What to Expect)

Dementia is progressive.

• Early stage: years of partial independence
• Middle stage: increasing dependence
• Late stage: complete care needed

With good care, patients:

• Remain calmer
• Have fewer complications
• Suffer less

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A Personal Note from My Practice

I have seen families break down—not because of memory loss, but because no one prepared them.

When families understand dementia:

• They become kinder
• Less angry
• More patient

Knowledge changes care.

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When to Seek Help Immediately

• Sudden worsening
• New aggression
• Hallucinations
• Refusal to eat
• Repeated falls

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Call to Reach / Appointment

📍 Mind & Mood Clinic, Nagpur (India)
👨‍⚕️ Dr. Rameez Shaikh, MD
Psychiatrist & Counsellor
📞 +91-8208823738

Early guidance can save years of suffering—for patient and family.

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Disclaimer

This blog is for educational purposes only.
It does not replace professional medical consultation.
Treatment must be individualized after clinical evaluation.

— Dr. Rameez Shaikh, MD