About Dementia...
Dementia is a scary word... We all know someone who is living with dementia, or who showed signs of dementia during the last years of their life, and we may think we know what the term means. However, dementia is actually NOT just one set of difficulties with one particular cause, but a whole category of disorders that vary widely in causes, in symptoms, and even in the extent to which they are treatable and reversible. Basically, dementia is a broad term that refers to significant, unexpected changes in a person's cognitive functioning that interfere with the performance of normal life activities... but the causes of those changes, and whether they are mild or severe, temporary or permanent, may actually vary widely. Two people with the same underlying cause for their cognitive changes can also experience very different challenges.
What does dementia look like? Well, that can vary greatly, also. Doctors used to assume that memory problems were the primary sign of dementia, and that surely can be true. But people show dementia in many different ways. Some experience notable personality changes. Others have trouble speaking or understanding language. Still other have difficulty navigating. Some may experience trouble with executing familiar motor sequences. Unexpected concentration/attention issues can occur. And of course, these and many other difficulties can occur in a huge variety of combinations.
What causes dementia? We've all heard of Alzheimer's Disease, but at least a third of all cases of dementia are not due to Alzheimer's. Strokes are another relatively common cause, but instead of coming on gradually and inevitably getting worse, cognitive symptoms due to strokes tend to begin suddenly, and may be reversible to some extent, as healing occurs. People can also experience dementia symptoms due to a variety of other medical conditions, some of which are temporary and treatable. Heavy substance use or multiple serious head injuries can also result in a progressive loss of cognitive functioning.
Most often, dementia occurs later in life, but that is not always the case: Strokes, head injuries, and brain tumors can happen to younger people, and one rare, genetic form of Alzheimer's tends to first show up in persons who are still in the their 50's -- though there are even a few now aging people who have this rare genetic profile, but have NOT developed dementia! Clearly, the causes of dementia are complex, and much more careful research is needed, to understand the various contributing factors and how they might interact, to affect cognitive functioning in any particular individual.
However... please don't be frightened by "doom and gloom" stories about how "the frequency of dementia is rapidly increasing"... Yes, there ARE more people around living with dementia of various types than there used to be, but that's because there are many more older people around than there used to be -- And because older people are far more likely to exhibit dementia, it's not surprising that there is more dementia around, too. However, the good news is that the overall likelihood of older persons experiencing dementia has actually DECREASED SUBSTANTIALLY over time. A March, 2025 article in the Journal of the American Medical Association (JAMA) entitled Changing Story of the Dementia Epidemic (see reference below) reported that adults who live into their 60's, 70's, 80's, or beyond now are actually much less likely to experience dementia than persons of the same ages in prior generations. For example, in 1984, about 30% of persons then in their 80's had been diagnosed with dementia, but by 2024, only about 10% of persons in their 80's had such difficulties.
Numbers and trends aside, it is still important for us to be aware that every person living with dementia has a unique set of challenges to manage. While dread and fear are very understandable feelings, when symptoms begin to occur, those very natural reactions can still make things worse, if they delay identification of the underlying causes and the initiation of any appropriate treatments. Trying to ignore or deny difficulties, while very understandable, can actually place the affected person at greater risk.
If you (or those who care about you) have questions about your ability to drive, your ability to live alone, your handling of personal business affairs, or any risks you may have taken, please listen to those concerns, and seek out medical evaluation and/or neuropsychological testing without delay. The more you know, the better the decisions you will make, to ensure your future well-being.
Changing Story of the Dementia Epidemic, by P. J. Eric Stallard, BS, Svetlana V. Ukraintseva, PhD, and P. Murali Doraiswamy, MBBS. JAMA. Published online March 12, 2025. doi:10.1001/ jama.2025.1897
Dementia is a scary word... We all know someone who is living with dementia, or who showed signs of dementia during the last years of their life, and we may think we know what the term means. However, dementia is actually NOT just one set of difficulties with one particular cause, but a whole category of disorders that vary widely in causes, in symptoms, and even in the extent to which they are treatable and reversible. Basically, dementia is a broad term that refers to significant, unexpected changes in a person's cognitive functioning that interfere with the performance of normal life activities... but the causes of those changes, and whether they are mild or severe, temporary or permanent, may actually vary widely. Two people with the same underlying cause for their cognitive changes can also experience very different challenges.
What does dementia look like? Well, that can vary greatly, also. Doctors used to assume that memory problems were the primary sign of dementia, and that surely can be true. But people show dementia in many different ways. Some experience notable personality changes. Others have trouble speaking or understanding language. Still other have difficulty navigating. Some may experience trouble with executing familiar motor sequences. Unexpected concentration/attention issues can occur. And of course, these and many other difficulties can occur in a huge variety of combinations.
What causes dementia? We've all heard of Alzheimer's Disease, but at least a third of all cases of dementia are not due to Alzheimer's. Strokes are another relatively common cause, but instead of coming on gradually and inevitably getting worse, cognitive symptoms due to strokes tend to begin suddenly, and may be reversible to some extent, as healing occurs. People can also experience dementia symptoms due to a variety of other medical conditions, some of which are temporary and treatable. Heavy substance use or multiple serious head injuries can also result in a progressive loss of cognitive functioning.
Most often, dementia occurs later in life, but that is not always the case: Strokes, head injuries, and brain tumors can happen to younger people, and one rare, genetic form of Alzheimer's tends to first show up in persons who are still in the their 50's -- though there are even a few now aging people who have this rare genetic profile, but have NOT developed dementia! Clearly, the causes of dementia are complex, and much more careful research is needed, to understand the various contributing factors and how they might interact, to affect cognitive functioning in any particular individual.
However... please don't be frightened by "doom and gloom" stories about how "the frequency of dementia is rapidly increasing"... Yes, there ARE more people around living with dementia of various types than there used to be, but that's because there are many more older people around than there used to be -- And because older people are far more likely to exhibit dementia, it's not surprising that there is more dementia around, too. However, the good news is that the overall likelihood of older persons experiencing dementia has actually DECREASED SUBSTANTIALLY over time. A March, 2025 article in the Journal of the American Medical Association (JAMA) entitled Changing Story of the Dementia Epidemic (see reference below) reported that adults who live into their 60's, 70's, 80's, or beyond now are actually much less likely to experience dementia than persons of the same ages in prior generations. For example, in 1984, about 30% of persons then in their 80's had been diagnosed with dementia, but by 2024, only about 10% of persons in their 80's had such difficulties.
Numbers and trends aside, it is still important for us to be aware that every person living with dementia has a unique set of challenges to manage. While dread and fear are very understandable feelings, when symptoms begin to occur, those very natural reactions can still make things worse, if they delay identification of the underlying causes and the initiation of any appropriate treatments. Trying to ignore or deny difficulties, while very understandable, can actually place the affected person at greater risk.
If you (or those who care about you) have questions about your ability to drive, your ability to live alone, your handling of personal business affairs, or any risks you may have taken, please listen to those concerns, and seek out medical evaluation and/or neuropsychological testing without delay. The more you know, the better the decisions you will make, to ensure your future well-being.
Changing Story of the Dementia Epidemic, by P. J. Eric Stallard, BS, Svetlana V. Ukraintseva, PhD, and P. Murali Doraiswamy, MBBS. JAMA. Published online March 12, 2025. doi:10.1001/ jama.2025.1897