By Dr. Gbonjubola Abiri
Few years ago, this elderly couple walked into my consulting room. The husband looked both concerned and weary. He gently held the arm of his wife, who smiled softly but seemed unsure of where she was.
As part of a routine cognitive assessment, I asked her a few questions. She told me her name, confidently. When I asked her age, she hesitated, looked at her husband, and then back at me. She smiled and said to her husband: “How old am I?”
Further questions added to the silence, agitation and confusion. Her husband explained that, over the past year, she had become increasingly forgetful, misplacing items and getting lost in familiar places. More recently, she had begun accusing him of conspiring against her. He was deeply pained, watching the love of his life slip away, right in front of his eyes, while also being cast as the enemy in her mind.
This is the face of dementia, not just memory loss, but a slow and painful unraveling of the mind, personality and relationships.
Dementia involves a significant and progressive decline in memory, thinking and the ability to perform daily activities which interferes with a person’s quality of life. While aging is the greatest risk factor for dementia, many people live cognitively healthy lives into old age. The most common cause of dementia is Alzheimer’s disease, but there are other types, including vascular dementia, Lewy body dementia, and frontotemporal dementia.
One of the earliest signs is short-term memory loss; forgetting names, appointments or recent conversations. Over time, it begins to interfere with language, judgment, spatial awareness and even emotional regulation. In some cases, as with the woman I described, psychotic symptoms like paranoia or hallucinations may develop, making caregiving even more challenging.
Dementia doesn’t just affect the individual as spouses become caregivers and children become decision-makers. Emotions run high through grief, frustration, guilt, confusion and helplessness. While there is no known cure for most types of dementia, early diagnosis can help in managing symptoms, slowing progression and planning care. Medications may help with memory or behaviour issues. More importantly, support, both medical and emotional, for caregivers is essential. It’s also crucial to focus on prevention strategies: staying mentally and socially active, managing chronic conditions like hypertension and diabetes, eating a brain-healthy diet and avoiding smoking or excessive alcohol.
Dementia is a growing public health concern, especially as populations age. More than that, it’s a human story, of fading memories, changing relationships and the continued need for compassion and support.
Remember, there is no health without mental health.