What Dementia Is — and What It Is Not
Dementia is not normal ageing. This is the most important thing to understand. Most people become somewhat more forgetful as they age — taking longer to recall a name, needing to write things down more, occasionally walking into a room and forgetting why. This is a normal, benign part of the ageing process. Dementia is something entirely different. It is a syndrome caused by diseases of the brain that progressively damage brain cells and their connections, leading to a decline in memory, thinking, language, behaviour, and the ability to carry out everyday activities — severe enough to interfere with daily function and quality of life. Alzheimer’s disease is the most common cause of dementia, accounting for 60 to 70% of cases. Vascular dementia — caused by damage to the brain’s blood supply through strokes and small vessel disease — is the second most common type. Both are increasingly prevalent as Nigeria’s population ages.
The Early Signs Families in Nigeria Tend to Miss or Dismiss
In Nigerian families, the early signs of dementia are frequently attributed to spiritual causes, to the person ‘acting strange’, to stress, or simply to being old. A grandmother who keeps asking the same question repeatedly within the space of an hour is not being difficult — she has genuinely no memory of having asked it before. A grandfather who gets lost walking a route he has walked a thousand times is not being careless — a part of his brain that created and stores spatial memory is damaged. An older parent who is increasingly suspicious of family members, accusing people of stealing things they have merely misplaced, or becoming agitated in the evenings in ways they never were before — these are behavioural changes driven by brain disease, not personality defects. Recognising them as symptoms rather than character issues is the first step towards getting the right help.
Signs That Should Prompt a Medical Assessment
- Repeatedly asking the same question or repeating the same story within a short time — with no awareness of having done so
- Forgetting recent events, conversations, or appointments while remote memories remain intact — this pattern, where recent memory is more affected than distant memory, is characteristic of Alzheimer’s
- Getting lost in familiar places — their own neighbourhood, the route to church
- Difficulty following a sequence — cooking a meal they have cooked hundreds of times, managing their bank account, following a conversation
- Difficulty finding the right words — using unusual substitutions (‘the thing you cook with’ for ‘pot’) or losing the thread of sentences
- Significant personality or behaviour changes — new paranoia, new aggression, new apathy, new sexually inappropriate behaviour
- Losing the ability to manage personal finances, pay bills, or plan and organise
- A gradual decline in self-care — hygiene, dressing, eating
The Difference Between Dementia and Normal Ageing
- Normal: forgetting where you put your phone and finding it later. Dementia: forgetting what a phone is for.
- Normal: occasionally forgetting a name but remembering it later. Dementia: not recognising a close family member.
- Normal: making an occasional error in a calculation. Dementia: being unable to manage money that was once handled easily.
- Normal: slowing down physically and mentally. Dementia: losing the ability to perform basic daily activities independently.
Why an Early Diagnosis Still Matters Even Without a Cure
There is currently no cure for Alzheimer’s disease, and this fact leads many Nigerian families to feel that pursuing a formal diagnosis is pointless. This reasoning, while understandable, costs people important opportunities. An early diagnosis allows the person with dementia — while they still have the capacity to do so — to participate in decisions about their own future care, their finances, and their wishes. It allows families to plan appropriately rather than being repeatedly blindsided by decline. It enables the investigation and treatment of reversible causes of cognitive impairment — thyroid disease, vitamin B12 deficiency, severe depression, and certain medication toxicities can all cause memory and thinking problems that are largely reversible when the underlying cause is treated. And it connects families with community support, social services, and information that makes the journey significantly more manageable.
Protecting Brain Health — What the Evidence Supports
- Physical activity is the single intervention most consistently associated with reduced dementia risk across multiple large studies — walking, dancing, and any sustained aerobic activity
- Managing cardiovascular risk factors — blood pressure, blood sugar, cholesterol — protects the brain’s blood supply and reduces vascular dementia risk
- Staying mentally active — reading, learning new things, playing strategy games, active social conversation
- Staying socially connected — social isolation is an independent risk factor for cognitive decline
- Getting enough sleep — the brain uses sleep to clear out metabolic waste products including amyloid, the protein that accumulates in Alzheimer’s disease
- Treating hearing loss promptly — there is now strong evidence that untreated hearing loss is a modifiable risk factor for dementia, possibly because social withdrawal from communication difficulties reduces cognitive stimulation
How Doc on Wheels Can Help
If you are concerned about memory or cognitive changes in yourself or an elderly family member, a doctor through Doc on Wheels can speak with you from home, conduct an initial cognitive screening, arrange relevant blood tests to rule out treatable causes, and refer to a specialist memory assessment where indicated. For families already navigating dementia, we can provide guidance on care, support, and what to expect. You do not have to manage this alone.