WHAT if knowing earlier could change what you do next? This is the question I want us to consider as we join the rest of the world tomorrow, September 21, to mark World Alzheimer’s Day. This year’s global campaign carries a particularly important message: ‘The Earlier You Know, The More You Can Do: A Dementia Diagnosis Matters.’ It is a message that deserves our attention because when it comes to memory problems, many families tend to wait. We notice that Mummy has started repeating herself, Daddy seems to be forgetting recent conversations, or a once independent relative is beginning to struggle with familiar activities, yet we often explain it away by saying, ‘It is just old age,’ ‘She is getting older,’ or ‘He has too much on his mind.’
Sometimes, these explanations may be correct. Stress, poor sleep, depression, anxiety, certain medications and some medical conditions can affect memory and concentration. But sometimes, there may be something more serious happening, and the only way to know is to have the person properly assessed. This is why awareness matters. We should neither panic over every memory lapse nor dismiss persistent changes simply because someone is getting older.
Last week, we talked about the difference between ordinary forgetfulness and memory changes that may need attention. Today, I want us to take that conversation further by understanding what dementia actually means and, more importantly, why finding out what is happening early can make such a difference.
Dementia is not one particular disease. It is a general term used to describe problems with memory, thinking, reasoning, communication and other cognitive abilities that become serious enough to interfere with a person’s everyday life and independence. There are different types of dementia, including vascular dementia, dementia with Lewy bodies and frontotemporal dementia. Alzheimer’s disease is the most common cause of dementia, but dementia itself is not synonymous with Alzheimer’s.
So, what happens in Alzheimer’s disease? In simple terms, think of the brain as an enormous communication network. Billions of brain cells, called neurons, constantly communicate with one another, allowing us to remember people and places, find our way around, understand conversations, make decisions and perform the countless activities that make up everyday life. In Alzheimer’s disease, abnormal proteins, particularly amyloid and tau, become involved in a process that disrupts the normal functioning and connections of these brain cells. Over time, the cells become damaged and die, and areas involved in memory and other thinking abilities can gradually be affected. This is why Alzheimer’s is much more than simply forgetting where you kept your keys.
The changes can begin gradually, which is one reason they are sometimes overlooked. A person may start forgetting recent conversations, asking the same question repeatedly, struggling to find familiar words, having difficulty managing money or medications, becoming confused about familiar places or finding previously routine tasks increasingly difficult. The important question is not simply, ‘Did you forget something?’ because all of us forget things. The more useful question is, ‘Is this a noticeable change from the person’s usual way of functioning, and is it beginning to affect everyday life?’
This is where early diagnosis becomes so important. A diagnosis does not necessarily mean that someone has Alzheimer’s disease. It can help healthcare professionals determine what may actually be causing the changes. Sometimes, there may be another medical or psychological condition contributing to the problem, and some causes of cognitive impairment can be treated. Without an assessment, families may spend months or even years guessing, worrying or simply attributing everything to ageing.
Knowing earlier can also provide access to appropriate treatment, care and support. Some treatments for Alzheimer’s are most useful in the earlier stages of the disease, while other interventions can help with symptoms, daily functioning and quality of life. Just as importantly, an early diagnosis gives families something that becomes increasingly difficult to find as a condition progresses: time. Time to understand what is happening, time to discuss wishes and preferences, time to make important financial and care decisions, and time for the person living with dementia to participate in those decisions while they are still able to do so.
This is particularly important in our families because we often become caregivers almost by default. One person may suddenly find themselves responsible for an ageing parent, managing medications, accompanying them to appointments, handling finances and making decisions that the parent previously made independently. When there has been no proper assessment, the family may interpret the person’s behaviour as stubbornness, laziness or simply ‘being difficult’. Understanding that there may be a change occurring in the brain can completely change how the family responds.
Imagine an older woman who keeps asking the same question. Instead of becoming frustrated and saying, ‘Mummy, I have told you this five times today,’ understanding the possibility of a memory problem may help the family respond with greater patience. Instead of asking, ‘Why can’t Daddy remember this anymore?’ we can begin to ask, ‘What is happening, and what support does he need?’ Sometimes, awareness does not change the condition itself, but it changes the way we care for the person experiencing it.
And this is why the brain does not suddenly become important when we turn 70. We spend years thinking about our heart, our blood pressure, our kidneys, our blood sugar and our general health. We go for checkups when something does not feel right and take treatment when necessary. Yet, we sometimes treat changes in memory and thinking as something we should simply tolerate because ageing is involved. Our brains deserve attention too, and brain health should be a lifelong conversation.
At the same time, we must not allow conversations about Alzheimer’s to create unnecessary fear. Forgetting someone’s name occasionally does not mean you have Alzheimer’s. Walking into a room and forgetting why you went there does not automatically mean dementia. A busy mind, tiredness, stress and many other everyday experiences can affect our ability to remember and concentrate. What should get our attention is a persistent or worsening change, especially when it begins interfering with a person’s ability to manage the activities they normally handle.
So, if you notice significant changes in memory, thinking, behaviour or everyday functioning in yourself or someone you love, do not panic, but do not simply dismiss them either. Talk to a qualified healthcare professional and have the changes assessed. You may discover that it is not dementia at all. You may discover another condition that needs attention. And if it is dementia, knowing earlier gives you and your family an opportunity to understand what is happening, seek appropriate care and support, make informed decisions and prepare for what lies ahead.
This World Alzheimer’s Day, perhaps we need to change the way we think about diagnosis. A diagnosis can certainly be frightening, but not knowing can leave a person and their family in a much more difficult position. Sometimes, knowing is not the end of hope. Sometimes, knowing is the beginning of knowing what to do.
The message of this year’s campaign is therefore one we should all take seriously: the earlier you know, the more you can do. And perhaps that is one of the greatest gifts we can give ourselves and the people we love, the courage to pay attention when something changes, the wisdom to seek help and the compassion to remember that behind every diagnosis is a person who still deserves to be seen, heard, respected and loved.