A beloved grandmother developed dementia in her mid seventies. She was moved to an old-age home far from her husband and children. When — on a trip back to those parts — I tried to visit her, I was told no; it is a long way out there on the bus… And she wouldn’t know you anyway.
I was prepared for the possibility that she wouldn’t know me. She had many grandchildren. I was not prepared for realizing that I would greatly offend people who did know me if I persisted in trying to see her.
So I never saw her again and she died some years later; I don’t know if she was alone… but one was not supposed to wonder about things like that.
It didn’t matter. Dementia was a heightened form of death where all sense of relationship was lost on both sides.
Because people today live longer, late life dementia shows up more frequently now. One response is to change the law, as in Quebec, so that people can request euthanasia in advance — to be carried out if they start to have motor or cognitive difficulties.
An approach that is more in keeping with traditional scientific medicine has been to focus on whether dementia can be delayed or its severity reduced. There is news on that front.
Is Dementia Treatable or Preventable?
Earlier this month in the Wall Street Journal, epidemiologist Tom Frieden talked about prevention strategies, writing about his own grandmother — who faced the same issues as mine:
Evelyn’s blood pressure crept up when she was in her 70s—nothing dramatic, just numbers that doctors called “normal for her age.” But high blood pressure — which two-thirds of Americans have — substantially increases dementia risk, pounding on artery walls in the heart, brain, kidneys and throughout the body. Had we controlled Evelyn’s blood pressure to 130/80 or lower, using medication and a low-sodium, potassium-enriched diet, her cognitive decline might have been delayed or prevented.
We Can’t Know For Sure, of Course
But can’t we resist the temptation to assume that dementia is “inevitable,” in the sense that it would typically happen no matter what else was in play? Nature is rarely like that.
Dr. Frieden is founder and CEO of Resolve to Save Lives, an NGO that works against global health threats. He is also the author of The Formula for Better Health (2025):
In The Formula for Better Health,Tom Frieden — named “the most influential leader in American public health since C. Everett Koop” by former Mayor Michael Bloomberg — reveals how to defeat the world’s deadliest diseases.
Drawing from decades leading New York City’s health department after 9/11, directing the CDC during the Ebola epidemic, and fighting tuberculosis and other lethal threats in India and around the world, Frieden combines compelling stories with insider knowledge to show you how to win the battle for health.
From the Publisher
Frieden also talks about the role that cholesterol, smoking, lack of exercise, and refusal to wear a hearing aid play in advancing dementia.
It’s Not Always “Dementia” Anyway
At Science Alert, Tessa Koumoundouros notes that dementia may be caused by a treatable health condition. Cognitive impairment, for example, may be caused by liver failure (hepatic encephalopathy):
More than 10 million new cases of dementia are recorded worldwide each year.
But a study published in 2024 suggests as many as 13 percent of people diagnosed with dementia in the US may actually be misdiagnosed and left struggling with a condition that can be treated. “Health care providers [must be] made aware of this potential overlap between dementia and hepatic encephalopathy, which is treatable,” said Virginia Commonwealth University hepatologist Jasmohan Bajaj in July 2024…
Much of this can be mitigated through changes in diet and behavior, and there are even more potential drug treatments on the horizon.
“Up to 13% of Dementia Diagnoses May Actually Be a Treatable Condition,” October 17, 2025
A number of other medical conditions can create symptoms that are misinterpreted as the onset of untreatable dementia, for example, “drug interactions, a urinary tract infection and vitamin B12 deficiency” (U.S, News, July 23, 2025).
One basic problem is that when young people begin to act confused, observers assume that they should look for drug abuse. When elderly people begin to act confused, observers may assume that the elderly people are “just naturally” becoming demented. So much less attention is paid to underlying causes.
Why Is Dementia More Common in Women?
At ZME Science, Tibi Puiu addresses an interesting research puzzle: Men experience greater brain loss as they age but women get Alzheimer types of dementia more often:
Women may be more likely to receive medical attention for memory issues, or they may live long enough to develop late-onset Alzheimer’s that men don’t survive to face.
What’s clearer now is that measuring brain volume alone won’t help explain the Alzheimer’s gap between men and women. The researchers call for more diverse data — beyond educated, healthy cohorts — to untangle how gender, genes, and environment shape neurodegeneration.
“Men’s Brains Shrink Faster Than Women’s With Age but Scientists Still Can’t Explain the Alzheimer’s Gap,” October 14, 2025 The paper is open access.
We definitely need more research on many topics in this area.
Note: I use the term “delay” rather than “prevention” for a reason: It may be that the human brain will inevitably start to break down after a century or so. But few human beings live that long. The attainable goal is to reduce the incidence of dementia in the seventies-through-nineties zone, which is reached by many people under modern conditions. That’s where avoiding known promoters of earlier dementia will pay off.