When most people think of dementia, the first word that comes to mind is Alzheimer’s. But dementia is not one story. Frontotemporal dementia (FTD) changes personality, vascular dementia follows silent strokes, and Lewy body dementia blends memory loss with hallucinations. Each has its own signature, and recognising this diversity is essential for better care. Yet in India, dementia is still largely misunderstood, often reduced to memory loss.
According to Dr Samant Darshi, Interventional Psychiatrist, Yatharth Superspeciality Hospitals, Psyberman MD – The Doctor of the Human Mind, "Families may not realise that the most distressing symptoms are often behavioural and psychological, agitation, aggression, apathy, wandering, paranoia, or hallucinations." These are called BPSD (Behavioural and Psychological Symptoms of Dementia), and they exhaust patients and caregivers alike. Unfortunately, our systems are still not designed to respond to them holistically.
The overlooked warning signs
Early dementia does not always begin with forgetfulness. Subtle changes often appear first:
- Difficulty following conversations
- Social withdrawal or loss of interest in hobbies
- Mood changes or sudden irritability
- Paranoia, compulsive behaviour, or loss of empathy (common in FTD)
Too often, these warning signs are dismissed as stress, normal ageing, or depression. The result? Delayed diagnosis and delayed treatment, at a time when interventions could make the most difference.
Shortcomings in current dementia treatment
"Even after diagnosis, care is often narrowly focused on memory loss. Symptoms like aggression, hallucinations, sleep disturbances, or wandering are overlooked. Non-drug interventions, caregiver training, structured routines, and cognitive stimulation are rarely provided in a systematic way," said Dr Samant.
The problem is not a lack of commitment from doctors or caregivers, but the siloed way our health system works. Dementia overlaps with neurology, psychiatry, geriatrics, and rehabilitation. Without integration, care remains fragmented.
Why India needs memory clinics
India urgently needs dedicated memory clinics in tertiary hospitals. These should bring together neurologists, psychiatrists, psychologists, geriatricians, and rehabilitation specialists. Such clinics can:
- Detect early warning signs with standardised assessments
- Manage BPSD alongside memory decline
- Support families and train caregivers
- Conduct clinical research tailored to Indian populations
Unlike the West, India still has the advantage of strong family and community structures. If we combine this cultural strength with clinical innovation, we can design a dementia care model that the world looks to.
Dr Samant said, "Dementia is not the end of meaning; it is the beginning of a new responsibility. India must not reduce dementia to Alzheimer’s alone, nor accept elderly homes as the only answer. By investing in memory clinics, interdisciplinary care, and community-based support, we can preserve not just life, but dignity and purpose."
Our duty is clear: to recognise early warning signs, respond with holistic care, and create systems that respect the human experience of dementia.
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