Dementia in India: Causes, Prevention, and How to Handle Agitation

Watching a parent repeat the same question three times in an hour, forget a grandchild's name, or grow restless and upset for no clear reason can be unsettling and confusing. These moments are often the first signs of dementia, a condition that's becoming increasingly common as India's elderly population grows. This guide covers what dementia actually is, how common it is in India, what you can do to lower your risk, what type of blood tests reports are usually done before, and how to handle one of its most difficult symptoms, agitation, including a recent development in how it's being treated.

What Is Dementia?

Dementia isn't a single disease. It's an umbrella term for a decline in memory, thinking, reasoning, or judgment severe enough to interfere with everyday life, like managing finances, cooking, or holding a conversation. Alzheimer's disease is the most common underlying cause, but other conditions such as vascular dementia, Lewy body dementia, and frontotemporal dementia also fall under this umbrella, each with slightly different patterns of symptoms.

It's worth distinguishing dementia from normal age-related forgetfulness. Misplacing your keys occasionally is normal. Forgetting what keys are used for, or getting lost on a familiar route, is not.

Most people associate dementia with old age, and that's usually accurate, but early onset dementia, which appears before age 65, does exist. It's less common but often harder to recognize early, since younger people and their families don't expect to see these symptoms and may attribute them to stress or depression instead.

How Common Is Dementia in India?

Dementia is more widespread in India than many people realize. A nationally representative study published in Alzheimer's and Dementia in 2023, using data collected between 2017 and 2020, found that an estimated 7.4 percent of Indians aged 60 and older live with dementia, which works out to roughly 8.8 million people. The same study found dementia is more common among women than men, and more common in rural areas than urban ones.

Other studies have produced somewhat different figures, ranging anywhere from around 3 percent to over 8 percent depending on the methodology used, which is normal for a condition that's diagnosed through clinical assessment rather than a single blood test. What's consistent across nearly all of these studies is the direction: as India's elderly population continues to grow, the number of people living with dementia is expected to keep climbing in the coming decades.

How to Prevent Dementia

There's no guaranteed way to avoid dementia entirely, since age and genetics play a role that can't be changed. But there's a real, well-researched reason for hope. The 2024 Lancet Commission on dementia prevention, a major standing panel of international experts, concluded that up to 45 percent of dementia cases worldwide are linked to 14 modifiable risk factors, meaning factors that can potentially be changed or managed.

These risk factors, spread across different stages of life, include:

• Low levels of education, particularly in early life
• Hearing loss left untreated
• High blood pressure
• Smoking
• Obesity
• Depression
• Physical inactivity
• Diabetes
• Excessive alcohol consumption
• Traumatic brain injury
• Air pollution exposure
• Social isolation
• High LDL cholesterol
• Untreated vision loss

For Indian readers, several of these carry particular weight. Managing blood pressure and diabetes through regular checkups, treating hearing and vision problems early instead of dismissing them as an inevitable part of aging, staying physically active, and maintaining strong social connections in later life are all practical, achievable steps. None of these guarantee prevention, but the evidence suggests they meaningfully lower risk over time.

What Is Agitation in Dementia?

As dementia progresses, many people experience agitation, which shows up as restlessness, irritability, emotional distress, or in some cases physical or verbal aggression. It can appear at any stage of the disease, not just in advanced cases, and it's widely considered one of the hardest symptoms for families and caregivers to manage, both emotionally and practically.

Agitation isn't a fixed, one-time event either. Once a person with dementia starts experiencing agitation, they tend to remain prone to it for an extended period, often years, which means it's usually an ongoing part of caregiving rather than something that resolves quickly.

What Triggers Dementia Agitation

Agitation is rarely random. It's often the person's way of communicating distress they can't otherwise put into words. Common triggers include:

• Unmet physical needs, such as hunger, thirst, pain, or needing the toilet
• Overstimulation from noise, crowds, or too much happening at once
• Unfamiliar environments or sudden changes in routine
• Fatigue or poor sleep
• Being asked too many questions at once, which can feel overwhelming
• Frustration from not being understood or not being able to express themselves

Recognizing agitation as communication, rather than defiance or bad behavior, often makes it easier for caregivers to respond calmly rather than reactively.

How to Handle Agitation in Dementia

Non-drug approaches are generally recommended as the first line of response, and they're often effective on their own.

• Identify the trigger. Look for patterns. Does agitation tend to happen at a certain time of day, around certain people, or in certain settings.
• Keep routines predictable. Consistency in meals, activities, and sleep schedules reduces confusion and anxiety.
• Reduce noise and overstimulation. A quieter, calmer environment often helps de-escalate agitation quickly.
• Use a calm, reassuring tone. Avoid arguing or correcting. Redirecting attention to a different activity is usually more effective than trying to reason through the moment.
• Check for unmet needs first. Pain, hunger, and the need to use the toilet are common, overlooked triggers.

When agitation becomes severe enough to risk the safety of the person or their caregivers, or when non-drug strategies aren't enough on their own, medical treatment may be considered.

A recent development worth knowing about: in April 2026, the US Food and Drug Administration approved a medication called Auvelity, a combination of dextromethorphan and bupropion, specifically for agitation associated with Alzheimer's dementia. This makes it the first non-antipsychotic treatment approved for this specific symptom, joining an earlier approved antipsychotic option. The approval was based on results from a series of clinical trials studying its effect on agitation symptoms in people with Alzheimer's. This is a notable step forward in a treatment area that has had very limited options, though as with any medication decision, it should only be considered in consultation with a qualified doctor, and availability may vary by country.

When to See a Doctor

Not every memory lapse needs a specialist, but certain signs warrant a proper evaluation. These include memory loss that's affecting daily functioning, sudden or significant changes in behavior or personality, agitation that's putting anyone's safety at risk, or any of these symptoms appearing in someone under 65.

It's also worth knowing that some conditions can mimic dementia symptoms but are actually reversible, including thyroid problems, vitamin B12 deficiency, and certain infections. This is one reason doctors often order blood tests as part of a dementia workup, to rule out these treatable causes before settling on a dementia diagnosis.

Getting Started

Dementia can feel overwhelming to face, both for the person experiencing it and for the family supporting them, but it's a condition that responds well to informed, patient care. Understanding what triggers agitation, building predictable routines, and staying on top of modifiable risk factors can make a real difference, both in prevention and in day-to-day caregiving.

If a loved one has had blood work done as part of a dementia evaluation and you're trying to make sense of the results, you can upload the report for a free plain-language analysis on Bharat Swasth's website or send it over on WhatsApp.

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Disclaimer: This content is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified doctor for diagnosis or treatment decisions.