Dementia Is Not Normal Ageing: Experts Urge Families to Act on Persistent Memory Loss

On October 26, in New Delhi, three geriatric specialists made the same point to PTI: forgetfulness can come with age, but persistent memory loss is not a normal part of growing old. They said repeated questions, trouble with familiar tasks and a steady decline in everyday functioning can signal dementia, and families should not wave them away.

Dr Harjit Singh Bhatti, consultant in geriatric medicine at Sitaram Bhartia Institute of Science and Research, drew the line plainly. Misplacing spectacles or taking longer to recall a name can happen with ordinary ageing. Dementia looks different: asking the same question again within minutes, forgetting an important conversation, getting lost in a familiar neighbourhood, or struggling with routine household work. He added that unexplained financial mistakes, difficulty managing medicines, language problems, and unusual suspicion, irritability or apathy also warrant medical evaluation.

Dr Shelly Dutta, Associate Professor of Medicine at RML Hospital, urged families to look for a pattern of progressive change rather than judge from one incident. Her test is whether forgetfulness interferes with managing daily life. Someone who has run a household independently for years and suddenly struggles with familiar tasks, repeatedly misses appointments or cannot handle routine financial transactions should be seen by a doctor. She said stigma, and the habit of blaming every cognitive change on old age, can delay diagnosis and make caregiving harder.

Dutta also offered practical advice. Families should approach the person with patience and dignity, avoid confrontation, and write down the changes they notice. A relative who knows the person well can give valuable information at a consultation, and early assessment gives families time to understand the condition, discuss safety and plan long-term support.

Dr Avinash Chakrawarty, Head of Geriatric Medicine at the National Centre for Ageing at AIIMS, Delhi, said diagnosis cannot rest on a single memory test or an isolated symptom. A proper assessment includes a detailed history from the individual and a close family member, a review of medicines, a neurological examination, and an evaluation of how cognitive changes affect daily activities. Doctors may use validated screening tools such as the Mini-Cog, the Mini-Mental State Examination and the Montreal Cognitive Assessment. Depending on the findings, blood tests for vitamin B12, thyroid function and metabolic abnormalities may follow, along with brain imaging where indicated.

That thoroughness matters, Chakrawarty said, because depression, sleep disorders, medication side-effects and certain medical conditions can also affect memory and concentration, and some of these causes are treatable. Not every instance of forgetfulness is dementia. He described dementia as an umbrella term for conditions that cause cognitive decline severe enough to affect independent functioning. Alzheimer's disease is the most common cause. Vascular dementia can follow damage to the brain's blood vessels. Dementia with Lewy bodies may involve visual hallucinations, fluctuating alertness and movement-related symptoms, and frontotemporal dementia can first appear as changes in personality, behaviour or language.

Bhatti said people who repeat questions, lose memory progressively, lose independence, or show cognitive changes alongside unexplained falls should seek assessment, especially if they have multiple illnesses or take several medicines. He noted that advances in blood-based biomarkers, brain imaging and disease-modifying treatments, including lecanemab and donanemab for eligible patients with early Alzheimer's disease in certain settings, have raised the importance of timely diagnosis.

The experts framed the push against the backdrop of India's expanding older population. Early recognition, they said, allows timely assessment, identification of treatable conditions, care planning and support for families. Bhatti summed it up: not every forgotten name should cause alarm, but persistent and progressive memory loss must not be ignored. Dementia cannot always be prevented, he said, but early recognition helps families reach appropriate care, plan for safety and support caregivers with greater understanding and dignity.