Monday, January 12, 2026

A Peek into Dementia

This week, we will be taking a peek into Dementia.

Why dementia? Because dementia is on the rise and one of the major reasons why maintaining brain health across the lifespan is being advocated globally. The rise in the number of people with dementia is not a statistic “cooked up” somewhere, we are seeing it increasingly in clinical practice. Some schools of thought suggest that if we all live long enough, we will eventually develop dementia, largely because ageing is the single most important risk factor. Others disagree, arguing that dementia is not an inevitable part of ageing.

What is clear, however, is this: dementia is becoming more common, and it affects far more than memory alone. It isn’t simply about forgetting names or misplacing items. It is much more than that. To understand this better, read the piece ''A reflection on Dementia''. Afterwards, we’ll reflect on what it teaches us about dementia.

"Dementia is becoming more common and affects far more than memory."

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Reflecting on the Fade: Why “The Person” Changes

The piece ''A Reflection on Dementia'' captures a painful reality many families face when caring for a loved one with dementia.

In the early stages, memory changes are either dismissed as normal ageing or are unnoticeable because symptoms start subtly.   Behavioural changes, however, frequently lead to frustration and anger from caregivers and family members who do not understand why someone they have always known begins to change.

This is reflected in one of the lines on "A Reflection on Dementia":

“Papa is getting so difficult… Mama was always tough, but now… she’s impossible.”

The tragedy is that dementia, not the person, is responsible for these changes.

"As dementia gradually changes an individual, families often find themselves struggling to relate to this 'new' person, and it is easy for frustration to occur. But we must remember: it is the disease, not the individual, causing these changes."

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So, What Is Dementia?

Dementia is a progressive disease of the brain that affects memory, behaviour, mood, language and thinking.  Eventually, these changes become severe enough to interfere with a person’s daily activities and their ability to live independently.

People with dementia have problems with: 

  • Memory function: Forgetting recent conversations and familiar faces or misplacing objects.
  • Behavioral shifts: Difficulty in social interactions or relating to others.

  • Mood swings: Rapidly shifting from happiness to deep sadness without an obvious trigger.

  • Physical & sensory changes: Sleep disturbances, hallucinations, and in advanced stages, they have difficulty speaking, swallowing, or moving.

It is important to note that symptoms vary depending on the type of dementia. The most common forms include Alzheimer’s disease, Vascular dementia, Lewy Body dementia, and Frontotemporal dementia, each presenting with its own distinct features.

"Dementia is far more than simple forgetfulness; it reshapes thinking, mood, and behavior."

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How does dementia occur?

It occurs when neurons (the nerve cells in the brain that act as the brain's communication network) begin to die or undergo some structural and functional changes. While some neuronal loss occurs naturally with ageing, in dementia this loss is exaggerated and accelerated, leading to changes in the brain (as seen in the image below). The changes account for the symptoms we see in individuals with dementia.  

Image of the brain in health versus dementia. 

In dementia, the brain becomes smaller, with thinner folds and wider spaces. This happens because brain cells are gradually lost, leading to problems with memory, thinking, and behaviour.

One key process involves the accumulation of abnormal proteins in the brain. In a healthy brain, these proteins are cleared away efficiently. In dementia, however, they build up and form "clumps" that trigger damaging reactions, eventually killing the neurons.

This is not an overnight process; these proteins can accumulate for over a decade before a person shows the first sign of forgetfulness. Factors such as poor brain development in childhood or prior brain injuries can make the brain more vulnerable, potentially causing symptoms to appear earlier or progress more rapidly.

"Dementia occurs when abnormal proteins accumulate in the brain over many years, forming 'clogs' that destroy neurons far more rapidly than natural aging. This decline is often accelerated in brains made vulnerable by injury or poor brain development in childhood."

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Over the next few weeks, we will explore:

  • Who is at risk of developing dementia?
  • Common causes and types of dementia.
  • How to tell normal ageing from early dementia?
  • Ways to reduce risk and protect brain health.
  • Treatment options and supportive care.

Please look out for the next posts in this important series. Because understanding dementia is the first step toward compassion, prevention, and better care.

Protecting your brain, protecting who you are.


Disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice.

Sunday, January 11, 2026

A Reflection on Dementia

A loved one who is with you, yet no longer with you—Mourning a loss while they are still alive.

It starts slowly—forgetting a little, here and there.
Forgetting conversations, a little here and there.
Repeating the same stories, a little here and there.
Misplacing objects, a little here and there.

Then it becomes more than “a little.”
The gaps in conversation grow wider.
The repeated words grow frequent.
The misplaced objects stay lost.

But it isn’t just the memory that fades, subtle changes take hold,
A shift in behaviour, restless nights,
Sudden mood changes,
Visions and voices only they can hear.

They drift into a world we cannot follow, then the whispers begin:
“Papa is getting so difficult,” they say.
“Mama was always tough, but now… she’s impossible.”
They do not see that dementia is the thief, quietly rewriting the person they once knew.

As the shadows deepen, recognition fails.
Mama looks at the daughter she raised as if she were a stranger.
Baba cannot recall the name or face of his youngest, his favourite.
Baba eats, but the table becomes a battlefield of crumbs.

Mama tries to cook, but her hands forget the recipes of a lifetime,
Moving with the uncertainty of a ten-year-old.
Only then does reality dawn.
Only then do the hospital visits begin.

But the tide continues to pull them away—
A little more, here and there.
Until the person you loved is no longer recognizable.
You see the body, but the person is gone.

You live with a stranger who does not know you—
And whom you no longer recognize.
You cry every day for the loss of a loved one,
Someone who is still with you, but no longer there.

— Adedunni Olusanya 


Disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice.

Sunday, January 4, 2026

Prioritizing Your Brain

Hello Everyone, 

It is a common misconception that only older adults need to pay attention to brain health because they are more likely to develop brain-related disorders. This is far from the truth.

Diseases of the brain affect all age groups. These include developmental disorders such as cerebral palsy, intellectual disability and learning disabilities that often begin early in life. It also includes others such as epilepsy, stroke, dementia and Parkinson’s disease. 

For conditions that typically appear later in life—such as dementia and stroke—the risk does not suddenly emerge in old age. Instead, vulnerability is shaped across the life course, beginning before conception, influenced by parental health, pregnancy, childhood experiences, and lifelong exposures.

                          ‘Diseases of the brain affect all age groups, not just the older adults.

‘For brain diseases occurring in later life, the risk does not suddenly emerge in old age. Risk sometimes begins from conception, through childhood to adulthood.’

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Brain Health Begins Before Birth; Both Fathers and Mothers Matter

The health of both parents plays a crucial role in how a child’s brain develops and the risk of neurological disease later in life. Poor nutrition, untreated medical conditions, medication misuse, substance abuse, and exposure to environmental toxins before and during pregnancy can interfere with optimal brain development.

Historically, attention focused almost exclusively on maternal health. However, emerging evidence shows that paternal age, health status, and substance use—especially alcohol—around the time of conception can also affect a child’s brain development. Brain health is not only about the mother; it is the duty of the father too.

‘Preconception health of the father is as important as that of the mother in protecting a child’s brain. Intending parents should pay attention to their health and the medications they use. It is not a bad idea to check in with your doctor.’

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Childhood: A Critical Window for Brain Development

From childhood through early adulthood, the brain undergoes rapid growth. This period is marked by the formation of new neurons, increased connections between neurons, and the development of myelin, which allows faster and more efficient communication within the brain. The extent of brain development during this period helps determine a child’s maximum intellectual and cognitive capacity.

Nutrition, sleep, quality education, emotional security, stimulation, and social interaction all contribute to building cognitive reserve. Children should be encouraged to explore, solve problems, and think independently. Allowing children to attempt tasks and assignments on their own before offering help promotes healthy brain stimulation- Nigerian Mamas and Papas, I am sure you understand!

Preventing and treating childhood illnesses is equally important. Some infections can cause lasting brain damage, leading to learning disabilities or epilepsy. Exposure to malnutrition, chronic stress, neglect, or environmental toxins can result in subtle brain injuries that may only become apparent later in life.

‘Childhood is a critical window for optimizing brain function because the brain grows rapidly during this period. Nutrition, sleep, quality education, emotional security, stimulation, social interaction and prompt treatment of diseases are important for optimal growth.’

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Adulthood: The Lifelong Impact of Lifestyle and Environment

As we age,  brain growth slows and the brain’s ability to repair itself declines.

At this point, maintaining brain health becomes increasingly important. Physical activity, adequate sleep, balanced nutrition, education, mental well-being, cardiovascular health, and social engagement all help preserve normal brain function.

In contrast, smoking, excessive alcohol use, illicit drugs, unmanaged stress, poorly controlled hypertension, diabetes, obesity, and environmental toxins accelerate brain decline by reducing the brain’s ability to repair itself.

‘As we grow older, the brain’s ability for self-repair reduces. Physical activity, adequate sleep, balanced nutrition, education, mental well-being, cardiovascular health, and social engagement are important dos at this point to maintain brain health.’

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Why This Matters Now

The global burden of brain-related diseases is rising; it is a leading cause of disability and a major cause of mortality worldwide. The increase is attributed to a rising prevalence of risk factors such as hypertension, diabetes and substance misuse. Each year, millions suffer strokes, and dementia prevalence continues to rise. 

According to the WHO, the number of people living with dementia is expected to increase significantly, especially in low- and middle-income countries like Nigeria. We are already beginning to see this in Nigeria, one Nigerian study reported a fourfold increase over a 20-year period! I am also seeing an increase in the number of people with dementia in my clinic compared to my experience about a decade ago

Without early prevention strategies that begin in childhood—or even before conception—the impact on families, healthcare systems, and economies will be profound.

‘Brain-related disorders are the number one cause of disability worldwide and a leading cause of death. The number of people with stroke and dementia is increasing globally and we need to take action to prevent this increase.’

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Protecting the Brain Across the Life Course

Protecting brain health requires intentional action at every stage of life:

Before conception: Optimize physical and mental health, manage chronic illnesses, avoid harmful substances (for both men and women).

During pregnancy: Ensure good nutrition, antenatal care, stress reduction, and avoidance of toxins.

Childhood: Promote good nutrition, education, sleep, play, and emotional security.

Adulthood: Maintain a healthy lifestyle, manage medical conditions, and stay mentally and socially engaged.

Older age: Continue physical activity, cognitive stimulation, and social connection while seeking early medical care.

‘Protecting your Brain and your Child's Brain must be intentional. It begins at the point of planning pregnancy to old age.’

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The Take-Home Message

Prioritizing brain health is a lifelong process, beginning even before conception and continuing into old age. What we do today shapes not only our own brain health but also that of future generations. You may not be the Einstein of your generation—but by protecting your health and your child’s brain health, you could raise the next one. 

Remember “Try to do the Dos. If you can’t do the Dos, don’t do the Don’ts.”

‘Protecting your brain is protecting who you are—and protecting your child’s brain is protecting the future.’


References 

1.        Steinmetz, Jaimie D et al., 2021. Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study.  The Lancet Neurology 23:4, 344 – 381. 

2.      Khemiri, Lotfi et al., 2023. Parental substance use disorder and risk of intellectual disability in offspring in Sweden: a national register study. eClinicalMedicine, Volume 63, 102170

3.     Livingston, Gill et al., 2024. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet, Volume 404, Issue 10452, 572 – 628

4.       WHO Dementia. https://www.who.int/news-room/fact-sheets/detail/dementia

5.     Adeloye et al., 2019. Prevalence of dementia in Nigeria: a systematic review of the evidence. J Glob Health Rep. 2019;3:e2019014. 


Disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice.

A Peek into Dementia

This week, we will be taking a peek into  Dementia. Why dementia? Because dementia is on the rise and one of the major reasons why maintai...