In short
Dementia is an acquired, persistent decline in memory, thinking and other cognitive functions that prevents a person from managing everyday tasks on their own. The first signs are most often forgetting recent events while memories of the past stay intact, asking the same questions over and over, trouble handling money, medications and household appliances, getting lost in familiar places, personality changes and apathy. Normal age-related forgetfulness does not affect independence. If changes keep building up over months, a consultation with a psychiatrist or neurologist is needed.
Key points in one minute
- Dementia is not a normal part of aging but a disease in which cognitive decline gets in the way of independent living.
- The main difference from normal forgetfulness: the person loses skills they used to have and does not notice their own mistakes.
- Some cognitive problems are reversible: in depression, vitamin deficiencies, thyroid problems or medication side effects.
- Early diagnosis makes it possible to start treatment, plan care and settle legal and financial matters while the person can still take part.
- Caring for a parent with dementia is a marathon: it is important to share responsibilities and protect your own health.
What Dementia Is and How It Differs From Normal Age-Related Forgetfulness
According to the WHO definition and ICD-10 criteria, dementia is a syndrome, usually chronic and progressive, in which memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgment are impaired. Consciousness remains clear. The key condition for the diagnosis is that the cognitive decline is severe enough to interfere with daily life. DSM-5 uses the term “major neurocognitive disorder,” while milder changes without loss of independence are called mild neurocognitive disorder (mild cognitive impairment).
With age, the speed of thinking really does slow down: it becomes harder to recall an acquaintance’s name, and small details slip away. But the person remembers the forgotten information later, uses reminders and notes, realizes they made a mistake and generally manages the household and finances. With dementia, entire recent events are forgotten, the person does not remember having already asked a question, gets lost on a familiar route, cannot make sense of bills, and denies mistakes or explains them by saying things were “stolen.”
Main Causes of Dementia
The most common cause is Alzheimer’s disease. It is followed by vascular dementia after strokes and with long-standing hypertension, dementia with Lewy bodies, frontotemporal dementia and mixed forms. Cognitive decline can also be linked to many years of alcohol misuse.
Reversible Causes of Memory Problems
Similar symptoms can be caused by depression in older age, vitamin B12 and folate deficiency, hypothyroidism, dehydration, infections, side effects of certain classes of medication, hydrocephalus and chronic subdural hematoma. That is why an assessment is essential: some of these conditions are treatable, and memory can recover.
Early Signs of Dementia That Relatives Notice
Changes often begin gradually and are noticed not by the person themselves but by their loved ones, especially if you do not see each other often. Relatives later recall that there were “warning bells” a year or two before seeking help: unpaid bills, expired food in the fridge, odd purchases, missed doses of medication. Pay attention not to a single episode but to a persistent pattern.
- Repeats the same questions and stories within a single conversation
- Forgets recent events, arrangements and conversations while remembering their youth well
- Gets confused about dates, days of the week and seasons
- Gets lost in familiar places and cannot find the way home
- Cannot manage money, bills or a bank card and becomes vulnerable to scammers
- Forgets to turn off the stove or the water, or to lock the door
- Struggles to find words and replaces them with descriptions
- Becomes suspicious and accuses family members of stealing things
- Loses interest in former activities, becomes apathetic and stops taking care of themselves
| Situation | Normal aging | Possible dementia |
|---|---|---|
| Forgetting | Forgot a name, then remembered it | Forgot an entire event and cannot recall it even with a hint |
| Daily tasks | Manages, sometimes more slowly | Cannot pay bills, cook a meal or take medications |
| Orientation | Occasionally mixes up the day of the week | Gets lost in a familiar neighborhood, does not know what year it is |
| Language | Sometimes struggles to find a word | Often loses the thread, substitutes words, repeats themselves |
| Attitude to mistakes | Notices them and is upset | Does not notice, denies them, blames others |
| Personality | Unchanged | Apathy, suspiciousness, irritability |
How Dementia Is Diagnosed
Cognitive impairment is diagnosed by a psychiatrist, especially a geriatric psychiatrist, and by a neurologist. At the first appointment the doctor asks relatives in detail: when the changes appeared, how quickly they progressed, and what the person has stopped doing on their own. This is followed by a conversation with the patient and neuropsychological testing — standardized scales that assess memory, attention, orientation, language and planning. It is important to come together with a relative who knows the older person’s daily life well.
To rule out reversible causes and clarify the type of dementia, the doctor orders blood tests, including thyroid function and vitamin B12 levels, as well as neuroimaging — an MRI or CT scan of the brain. Mood is assessed separately: depression in older adults can look like dementia, and depression often develops alongside dementia. The earlier the assessment is done, the more options there are to influence the course of the disease.
What Can Be Done Online
During a video consultation, a psychiatrist can take a detailed history from relatives, carry out some of the screening tests, assess mood, behavioral problems and sleep, and review existing test results and the current medication list. This helps determine how urgently an in-person assessment is needed and what exactly should be checked.
What Requires an In-Person Visit
A neurological examination, MRI or CT, laboratory tests and full neuropsychological testing are done in person. In case of sudden deterioration — acute confusion, sudden weakness in an arm or leg, or speech problems — emergency care is needed, not a scheduled consultation.
How to Prepare for a First Consultation About Dementia in a Parent
- Write down your observationsNote which changes you have noticed, when they started and how they progressed. Give concrete examples from everyday life.
- Make a list of medicationsWrite down all medications, including over-the-counter and herbal products, with how they are taken. Some classes of medication worsen memory.
- Gather medical recordsBring discharge summaries, test results, MRI or CT scans, and reports from a cardiologist or neurologist if you have them.
- Discuss the visit with your parentExplain that the consultation is to check their memory and overall well-being. Avoid words that sound like an accusation.
- Write down your questionsNote what worries you most: safety, sleep, behavior, whether a caregiver is needed, legal matters.
- Agree on who will be the contact personChoose one or two relatives who will communicate with the doctor and make sure the recommendations are followed.
How Dementia Is Treated and Whether Its Progression Can Be Slowed
Most forms of dementia cannot yet be fully cured, but it is possible to influence the rate of progression and quality of life. For Alzheimer’s disease and some other forms, a doctor may prescribe medications from the cholinesterase inhibitor and NMDA receptor antagonist classes, which temporarily stabilize cognitive function in some patients. In vascular dementia, controlling blood pressure, blood sugar and cholesterol and preventing further strokes is crucial. Choosing treatment is the doctor’s job; giving medications to an older person on your own is dangerous.
Non-drug approaches are just as important: regular physical activity, social contact, cognitive stimulation, a familiar daily routine, and treating hearing and vision problems. Behavioral symptoms — anxiety, agitation, sleep problems, suspiciousness — are first addressed by changing the environment and the way of communicating, and only if necessary does the doctor prescribe medication, taking into account older people’s increased sensitivity to side effects.
How to Organize Help and Care for a Parent With Dementia
Once the diagnosis is made, the family will need to restructure its life, and it is better to do this in advance rather than in a crisis. Hold a family meeting: who will handle medical matters, who will handle finances, who will visit and how often. While your parent can still make decisions, discuss their wishes regarding treatment, living arrangements and property, and arrange the necessary powers of attorney with a notary. In Kazakhstan, if a person’s ability to understand their actions is significantly reduced, the question of legal capacity can only be decided by a court.
Home safety is often more important than any medication. Good lighting, no slippery rugs, grab bars in the bathroom, control over the gas stove, a pill organizer with compartments for each day, and a bracelet or card with contact details in case the person gets lost. Speak in short sentences, do not argue with mistaken statements, and redirect attention. And remember yourself: caregiver burnout is common, and you too may need the support of a psychotherapist or a support group.
- Make a list of all medications being taken and show it to the doctor
- Set a consistent daily routine with the same times for sleep and meals
- Make the home safe: gas, water, sharp objects, access to medications
- Set up oversight of finances to protect your parent from scammers
- Arrange legal documents while the person can still express their wishes
- Agree on a care schedule among relatives or with a paid caregiver
- Plan time off for yourself and do not hesitate to ask for help
How Psychiatry Online Helps Families Facing Dementia
For relatives, the online format is especially convenient: you can get a consultation from home without taking an elderly person to an unfamiliar place, and bring siblings from other cities into the conversation. A psychiatrist will help assess how much the changes resemble dementia, suggest which tests are needed first, work through behavioral difficulties — nighttime restlessness, irritability, suspiciousness — and advise on how to handle difficult situations.
If the relative caring for the patient is struggling with emotions, exhaustion and guilt, individual psychotherapy can help. If necessary, a doctor’s home visit or a referral for inpatient treatment is available. We explain honestly which tasks can be handled remotely and which require an in-person neurological examination, neuroimaging or lab tests.
When to see a doctor
- Forgetfulness has been increasing for several months and makes it hard to manage daily life
- Your parent can no longer handle money, medications or household appliances
- Disorientation has appeared: gets lost on familiar routes, confuses time and place
- Personality has changed: apathy, suspiciousness, unfounded accusations
- Insomnia, nighttime restlessness or wandering around the home have appeared
- The older person shows signs of depression: low mood, refusing food, tearfulness
- The relative providing care feels they can no longer cope
When urgent help is needed
If an older person suddenly — within hours or days — becomes confused, does not recognize loved ones or sees things that are not there, this may be delirium caused by an infection or dehydration. Sudden weakness in an arm or leg, a drooping face or slurred speech are possible signs of a stroke. In these situations, call 103 or 112 without delay.
How Psychiatry Online can help
Same-day video consultation from any city in Kazakhstan, doctor home visits in 45 cities, and online follow-up. Confidential, with no registry entry.
- Geriatric psychiatrist onlinefrom 13 000 ₸ · Online 24/7
- Psychiatric consultation for family membersfrom 12 000 ₸ · Online 24/7
- Psychiatrist home visitfrom 15 000 ₸ · Online 24/7
Questions and answers
At what age does dementia start?
Dementia most often develops after age 65, and the risk increases with each decade. However, there are also early-onset forms that begin at 50 or even earlier, such as frontotemporal dementia or early-onset Alzheimer’s disease. That is why persistent problems with memory and behavior at any age require an assessment rather than being put down to tiredness.
Can dementia be cured?
Most forms of dementia cannot yet be fully cured, but treatment can slow progression, reduce behavioral symptoms and extend the period of independence. In addition, some cognitive problems are caused by reversible factors — depression, vitamin deficiencies, hypothyroidism or medication side effects. Addressing them can significantly improve memory.
Which doctor treats dementia?
Dementia is diagnosed and treated by a psychiatrist, especially a geriatric psychiatrist, and by a neurologist. The psychiatrist assesses cognitive function, mood and behavioral problems, while the neurologist assesses neurological status and vascular factors. They often work together, and a general practitioner, cardiologist or endocrinologist may be involved when needed.
How can I persuade my parent to have a memory assessment?
Do not bring up dementia head-on. It is better to suggest a “general health check,” “checking blood pressure and memory” or “sorting out sleep problems,” or to link the visit to another complaint. It helps if the idea comes from a doctor your parent trusts. An online consultation for relatives at Psychiatry Online lets you get started without the older person being present and plan the next steps.
Is dementia hereditary?
Having a parent with dementia slightly increases your risk, but in most cases the disease is not passed on directly. Inherited forms with a clear genetic cause are rare and usually start early. Modifiable factors matter much more: blood pressure, diabetes, smoking, physical inactivity, alcohol misuse, hearing loss and social isolation.
What should I do if my parent with dementia accuses me of stealing?
Do not argue or try to prove you are right — that increases anxiety. Acknowledge the feeling: “It’s upsetting that your things went missing,” offer to look for them together, then redirect their attention. Remember the usual places where the person hides things. If the suspiciousness becomes constant or frightening, discuss it with a psychiatrist.
Can a person with dementia be left home alone?
In the early stage, many people with dementia live independently with regular support. As the disease progresses, the risks grow: a stove left on, running water, wandering away from home, medication errors. The decision is made by assessing specific skills and safety, and it is reviewed as the condition changes. A caregiver or daytime supervision is often needed.
Sources and methodology
- ICD-10 and ICD-11, World Health Organization
- DSM-5, American Psychiatric Association
- NICE guideline NG97 “Dementia: assessment, management and support for people living with dementia and their carers”
- WHO Global action plan on the public health response to dementia
- Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”
This article was prepared by the Psychiatry Online medical editorial team and reviewed by a doctor. It is for reference only and does not replace a specialist consultation. Editorial policy
Reviewed by
Pavel Kornilov, MDPsychiatristDepression, anxiety disorders, OCD, bipolar disorder; online medication selection and adjustment.
