Dementia is no longer rare, say neurologists: India must pay attention

It usually begins quietly. A parent misplaces their keys and laughs it off. A grandparent forgets a neighbour’s name. Someone repeats the same story twice at dinner. In most Indian homes, these moments are brushed aside with a familiar line, “It’s just old age.” And life moves on.But what if it’s not that simple?Across India, dementia cases are rising steadily. Doctors are seeing more patients in their 50s, 60s and 70s walking into clinics with memory complaints that go beyond the occasional lapse. At the same time, families are struggling to understand what’s normal aging and what isn’t. The problem is, we don’t talk about it enough. Memory loss still carries stigma. Many people feel embarrassed. Others are in denial. Some simply don’t know the signs. India is getting older as a country. We’re also dealing with more diabetes, hypertension, stress and heart disease, all of which quietly affect brain health. Yet dementia remains one of the least discussed health issues in family conversations.So why is it rising? Why is it still misunderstood? And is our healthcare system even ready for what’s coming? Three leading neurologists break it down.Dementia cases are climbing largely because Indians are living longer. As Dr. Namita Kaul, Director-Neurology at Medanta Hospital Noida, explains, age remains the strongest risk factor. With India’s over-60 population expected to double by 2050, the number of dementia cases is naturally set to rise.But longevity isn’t the only reason. Dr. Biplab Das, Director of Neurology & Interventional Neuroradiology at Batra Hospital, points to India’s fast-growing elderly population, along with more people surviving strokes and heart disease. Urban air pollution, processed diets, sedentary habits, and rising metabolic disorders are further damaging brain health.Adding to this, Dr. (Prof.) Kunal Bahrani, Chairman & Group Director Neurology at Yatharth Super Speciality Hospital, highlights the role of diabetes, hypertension, and cardiovascular disease. It is to be noted that all three diseases have high prevalence in India. All three specialists agree: stigma and denial are major barriers. Dr. Kaul says many families still see dementia as “normal aging” or even fate. That belief delays conversations and medical consultations.Dr. Das adds that cognitive decline is emotionally difficult to accept. Families often prefer to manage it privately, especially in joint households where early signs can be quietly absorbed into daily caregiving. Women frequently shoulder this burden, making the issue largely invisible.Dr. Bahrani points out that in many communities, mental health and memory disorders remain taboo. Changes in behaviour or memory are treated as family matters, not medical concerns, which keeps the discussion behind closed doors.Very often. According to Dr. Kaul, memory lapses are routinely brushed aside as “just getting old.” But symptoms like forgetting familiar people or getting lost are not part of healthy aging.Dr. Das explains that subtle signs, like repeating questions, struggling with finances, are easily missed in early stages of dementia which then delays diagnosis of the disease.Lifestyle diseases are central to India’s dementia burden. Dr. Kaul notes that diabetes can double the risk of dementia. Hypertension and dyslipidaemia contribute to vascular dementia by damaging blood vessels in the brain.Dr. Das explains that poorly controlled blood sugar and blood pressure reduce blood flow to the brain. Dr. Bahrani adds that obesity, sedentary habits, and cardiovascular disease further strain brain health. “Anything that harms the heart ultimately affects the brain,” the doctors agree.The most persistent myth, says Dr. Kaul, is that dementia is simply aging and nothing can be done. In reality, early diagnosis allows better risk control and symptom management.Dr. Das encounters even more misconceptions, that dementia is infectious, a punishment, or curable with tonics. Public education campaigns and clearer communication are essential, he says.Dr. Bahrani stresses that dementia affects thinking, behaviour, and daily function as well. While current medications are limited, emerging anti-amyloid therapies may help in early stages.The doctors warn of a growing crisis. Dr. Kaul says rising dementia cases could strain families and healthcare systems alike. Also because of this women disproportionately would carry caregiving responsibilities.Dr. Das points out that as family sizes shrink and migration increases, fewer caregivers will be available. This could reduce workforce participation among middle-aged adults and increase dependency burdens.Dr. Bahrani cautions that without structured policies and support systems, India risks overwhelming both its public health infrastructure and family units. Medical experts consulted This article includes expert inputs shared with TOI Health by: Dr. Namita Kaul, Director-Neurology at Medanta Hospital NoidaDr. Biplab Das, Director of Neurology & Interventional Neuroradiology at Batra HospitalDr. (Prof.) Kunal Bahrani, Chairman & Group Director Neurology at Yatharth Super Speciality HospitalInputs were used to explain why dementia symptoms are ignored, and what are the social and economic burden of the growing crisis.