New Delhi

Forgetfulness may accompany ageing, but persistent memory loss, repeating questions and difficulty performing familiar tasks could signal dementia and should not be dismissed as a normal part of growing old, experts say.

With India's ageing population expanding, early recognition of dementia is crucial to ensure timely assessment, identify treatable conditions, plan appropriate care and support families dealing with the progressive condition, they said.

Dr Harjit Singh Bhatti, consultant in geriatric medicine at Sitaram Bhartia Institute of Science and Research, said families should pay attention when an older person begins showing persistent changes in memory, behaviour or everyday functioning.

“Occasionally forgetting where you placed your spectacles or taking longer to recall a name can occur with normal ageing. Dementia is different. Repeatedly asking the same question within minutes, forgetting an important conversation, getting lost in a familiar neighbourhood or struggling with routine household tasks are warning signs,” he said.

Unexplained financial mistakes, difficulty managing medicines, language problems and unusual suspicion, irritability or apathy also warrant medical evaluation, Bhatti said.

Dr Shelly Dutta, Associate Professor, Medicine, at RML Hospital said families should look for a pattern of progressive changes rather than judge memory problems by an isolated incident.

“An important distinction is whether forgetfulness begins to interfere with a person's ability to manage everyday life. If someone who has independently handled household responsibilities for years suddenly struggles with familiar tasks, repeatedly misses appointments or cannot manage routine financial transactions, the family should seek medical advice,” Dutta said.

She emphasised that stigma and the tendency to attribute all cognitive changes to old age could delay diagnosis and make caregiving more difficult.

“Families should approach the person with patience and dignity, avoid confrontation and document the changes they observe. A relative who knows the person well can provide valuable information during a medical consultation. Early assessment also gives families time to understand the condition, discuss safety and plan long-term support,” Dutta said.

Dr Avinash Chakrawarty, Head of Geriatric Medicine at National Centre for Ageing at AIIMS, Delhi said dementia assessment requires a comprehensive clinical evaluation and cannot be based on a single memory test or an isolated symptom.

“The assessment should include a detailed history from the individual and a close family member, a review of medicines, neurological examination and an evaluation of how cognitive changes affect daily activities. Doctors may use validated screening tools such as the Mini-Cog, Mini-Mental State Examination and Montreal Cognitive Assessment to identify possible cognitive impairment,” he said.

Depending on the findings, investigations may include blood tests to check vitamin B12 levels, thyroid function and metabolic abnormalities, along with brain imaging where indicated.

“Depression, sleep disorders, medication side-effects and certain medical conditions can also affect memory and concentration. Some of these causes are treatable, which is why it is important not to assume that every instance of forgetfulness is dementia,” Chakrawarty added.

Dementia is an umbrella term for conditions that cause a decline in cognitive abilities severe enough to affect independent functioning. Alzheimer’s disease is its most common cause, he said.

Vascular dementia can result from damage to the brain’s blood vessels, while dementia with Lewy bodies may involve visual hallucinations, fluctuating alertness and movement-related symptoms. Frontotemporal dementia can initially manifest through changes in personality, behaviour or language, Chakrawarty stated.

Bhatti said people repeating questions, experiencing progressive memory loss, declining independence or cognitive changes accompanied by unexplained falls should seek assessment, particularly when they have multiple illnesses or take several medicines.

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 increased the importance of timely diagnosis, he said.

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“Not every forgotten name should cause alarm, but persistent and progressive memory loss must not be ignored. We may not be able to prevent every case of dementia, but early recognition can help families access appropriate care, plan for safety and support caregivers with greater understanding and dignity,” Bhatti said.