Dementia: What It Is and How to Recognise It

Dementia is a serious condition that develops gradually, and in its early stages it can easily be mistaken for ordinary fatigue or stress. Understanding what is actually happening in the brain — and what the early markers look like — helps ensure that the right moment for seeking help is not missed.

Two main types: vascular dementia and Alzheimer's disease

In vascular dementia, atherosclerotic plaques form in the brain's arteries, disrupting blood flow and depriving the brain of adequate oxygen and nourishment. The course is often wave-like: symptoms worsen in autumn and winter, then ease in spring as warmth returns and familiar surroundings — a garden, known streets — seem to revive the person. These cycles can repeat for years.

Alzheimer's disease presents differently. Those affected are typically precise, organised people with good memories — up to a point. One characteristic early sign is waking very early and not getting enough sleep. Disorientation in familiar surroundings follows.

What it looks like: early markers

• Sleep disturbances — especially early waking and restless nights.
• Confusion episodes — the person does not recognise family members, cannot tell where they are or what time of day it is, and may appear bizarrely agitated. These episodes are directly linked to disturbed sleep and anxiety.
• Disorientation in familiar places — someone who has lived in the same city their whole life drives out and cannot find the way home.
• Psychotic episodes as the condition progresses — confabulation, delusions of harm or jealousy, hearing voices.

With Alzheimer's it's different: left the pot on the stove, forgot to turn off the gas.

What family members need to understand

A person's behaviour in dementia — forgetfulness, repeated trips to the refrigerator, agitation — is a symptom of the disease, not wilful stubbornness or a reason for irritation or mockery. Unprofessional care without an understanding of the condition causes suffering both to the person with dementia and to the caregiver: over time, the carer develops sleep problems, anxiety, and low mood of their own.

People don't know that this is treatable — that antidepressants, antipsychotics, and specific medications that improve sleep and mood need to be given.

Dementia responds to treatment. Seeking specialist help early changes the outcome.