The connection between chronic diseases and dementia

Dementia describes a group of symptoms affecting memory, thinking and social abilities. Several diseases can cause dementia. Memory loss is one of the early symptoms of dementia. As highlighted during recent presentations put on by the Alzheimer’s Association, the prevalence of dementia, including Alzheimer’s dementia, is increasing globally, including here in the Caribbean.

Dementia is an overall term to describe a collection of symptoms that one may experience if they are living with a variety of diseases. Diseases grouped under the general term “dementia” are caused by abnormal brain changes. Dementia symptoms trigger a decline in thinking skills, also known as cognitive abilities, severe enough to impair daily life and independent function. They also affect behaviour, feelings and relationships.

Dementia is not simply a matter of someone getting “old and forgetful”. It is not a natural part of ageing. People suffering from dementia are unable to take care of themselves; they cannot take care of personal hygiene and are unable to complete personal tasks that require reasoning and understanding. They are totally dependent on a caregiver to keep them alive.

A dementia caregiver is an individual who provides support and care for someone with dementia, typically a family member such as a spouse or adult child, although professional caregivers also exist. This role involves assisting with daily living tasks, managing medications, providing emotional support, and helping to create a safe and calming environment. It is a demanding position that requires significant emotional, mental, and physical effort. Caregivers must prioritise their own well-being by seeking support, managing stress, and ensuring their own needs are met to prevent burnout.

In some cases, the challenge of taking care of a person with dementia causes some families to “abandon” their relatives in nursing homes, geriatric institutions and sometimes even in Emergency Departments.

Alzheimer’s disease accounts for 60–80 per cent of cases of dementia globally. Vascular dementia—dementia caused by poor blood flow to the brain—is the second most common type of dementia. Those who experience the brain changes of multiple types of dementia simultaneously have mixed dementia. Many other conditions can cause symptoms of cognitive impairment but aren’t dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.

Dementia is often incorrectly referred to as “senility” or “senile dementia”, which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of ageing.

Dementia symptoms are progressive, which means that the signs of cognitive impairment start out slowly and gradually get worse over time, leading to dementia. If you or someone you know is experiencing memory difficulties or other changes in thinking skills, don’t ignore them.

While most changes in the brain that cause dementia are permanent and worsen over time, thinking and memory problems caused by the following conditions may improve when the condition is treated or addressed: depression; medication side effects; excessive use of alcohol; thyroid problems; vitamin deficiencies.

Dementia prevention involves adopting a healthy lifestyle by maintaining physical and mental activity, eating a balanced diet, managing heart health, avoiding smoking and excessive alcohol, protecting your head from injury, and treating hearing loss. Regular health check-ups and staying socially connected also play a significant role in reducing your risk of developing dementia.

Recent information from the International Diabetes Federation (IDF), presented at a webinar on 9/22/2025, titled The link between diabetes, dementia and an ageing population, showed that after studying almost 13 million people:

·   People who had diabetes had a 56 per cent higher risk of developing dementia than people who did not have diabetes. Further, the earlier one develops diabetes, the greater the risk of developing dementia in later life. This strongly suggests we need to prioritise mid-life interventions.

·   People with diabetes had a 34 per cent increased risk of developing Alzheimer’s disease compared to people without diabetes.

·   People with diabetes had a 203 per cent greater risk of vascular dementia (VAD) than people without diabetes.

·   The shared risk factors for diabetes and dementia include hypertension, chronic kidney disease, obesity, cardiovascular disease, strokes and physical inactivity. These are the non-communicable diseases (NCDs). In many Caribbean populations, childhood obesity is fuelling the appearance of NCDs and their complications at earlier and earlier ages. Many of these conditions can be prevented with the appropriate effort; early diagnosis and appropriate intervention can lead to control of these conditions and reduce the likelihood of complications developing. Research is ongoing on the specific use of some antidiabetic and antihypertensive agents in the prevention or treatment of dementia.

·   Dementia risk reduction strategies must target these risk factors, the sooner the better.

·   About seven per cent of global deaths are due to dementia, so dementia kills.

·   Dementia affects more women than men. Most of the caregivers are women. These caregivers need support.

·   There is no cure for dementia, but there are some disease-modifying drugs, both now and a few more on the horizon.

·   Less than half of the countries in the world have Dementia Risk Reduction (or NCD Reduction) strategies. There is thus an ideal opportunity for Barbados and the wider Caribbean to act now by integrating dementia prevention into NCD strategies, supporting caregivers, and investing in early interventions.

In addition, organisations like the Alzheimer’s Association require full support.

Dr Colin V Alert is a family physician and former researcher with the Chronic Disease Research Centre.