Dementia or Alzheimer not a disease, but a condition: Experts

Kathmandu, Oct. 5: Hareram Pathak, 74, from Samakhusi, Kathmandu, used to live in an elderly care centre close to his home until a few months ago. One afternoon, he sneaked out of the care centre without notifying anyone.  He himself didn’t know where he was headed. The staff at the care centre realised his absence only in the evening. They immediately informed the Pathak family, but Hareram hadn’t gone home either.

Family members, along with the care centre staff, searched all over Kathmandu for two days. Arjun Bhetwal, one of Pathak’s relatives, said they checked the CCTV footage from every police station. 

“Finally, we found him in the Godawari area on the third day. CCTV footage showed that he had walked continuously — day and night — passing through Lainchaur, Hattisar, Gaushala, Tinkune, Koteshwor, and Satdobato,” said Arjun.

After finding Hareram at a stranger’s home in Godawari, the family asked him why he had left and where he had been. Hareram reacted lightheartedly and jokingly said he wanted to go back to his village, leaving behind some suspicious symptoms of dementia.

After rescuing Hareram, the family took him to several doctors. Bhawana Pathak, Hareram’s granddaughter, said they visited at least four different doctors frequently. “After a series of checkups, we found out that our grandfather is suffering from severe dementia,” said Bhawana.

These days, Hareram is living at home with at least one caretaker at all times. According to his family, Hareram has no other health issues apart from dementia. He can still recall past events, but not recent ones.

Another family of Sitaram Poudel from Chitwan, is also facing a similar situation. Durga Devi Poudel, 81, mother of Sitaram, has been suffering from dementia for the past few years. She can no longer recognize her own son or grandchildren. “She doesn’t even realize when she’s hungry. She cannot be left home alone,” said Sitaram.

According to data released by the Rapti Institute of Health Sciences, at least three out of every 100 elderly people in Nepal are diagnosed with dementia or Alzheimer’s. Dr. Ramesh Kandel, a senior expert in elderly diseases, said dementia cases have surged recently. “At least 100 senior citizens visit the OPD daily, and three of them are diagnosed with dementia or Alzheimer’s disease,” said Dr. Kandel.

He also mentioned that dementia or Alzheimer’s is most common after the age of 60, and is considered one of the major health challenges in old age.

Differences between dementia and Alzheimer’s

Many people commonly refer to all types of dementia as Alzheimer’s. However, experts clarify that Alzheimer’s is a specific form of dementia, while dementia refers to a general decline in cognitive ability. 

Individuals with dementia typically struggle with forgetfulness. The disease leads to the death of brain cells, particularly in older adults.

There are several types of dementia. Alzheimer’s is the most common, accounting for 50 to 70 per cent of all dementia cases. Other types include vascular dementia, Lewy body dementia, frontotemporal dementia, normal pressure hydrocephalus, Parkinson’s disease, syphilis, and Creutzfeldt-Jakob disease.

Dementia is generally classified into four stages based on severity, such as Mild cognitive impairment, Mild dementia, Moderate dementia, and Severe dementia.

When an individual begins losing their memory, it could be an early sign of dementia. One study claims that about 10 per cent of people will develop dementia at some point in their lives. About 3 per cent of people aged 65–74, 19 per cent aged 75–84, and nearly 50 per cent of those over 85 may develop dementia.

What are the symptoms?

According to experts, early signs of dementia include repeating the same stories or questions during conversations. As the disease progresses, individuals struggle with daily tasks they previously managed easily. In advanced stages, they may become completely dependent on others for everyday functions.

Dr. Kandel noted that elderly people suffering from forgetfulness often forget what they were talking about mid-sentence.

According to the latest data released in 2025 by the Nepal Health Research Council, around 150,000 people in Nepal are recorded as having dementia or Alzheimer’s. This data was collected through research involving 933 individuals over the age of 60 from various districts across the mountains, hills, and Tarai regions.

Dr. Kandel stated that there is no cure yet for dementia. While medications may help manage symptoms or delay progression, they cannot completely cure the disease.

Social side of dementia

In some cases, senior citizens are considered a burden by their families. They are often blamed for being overly demanding or are simply ignored.

Many cases have shown that elderly people with dementia are subjected to mistreatment or neglect by their families.

Some experts argue that Nepal needs dedicated hospitals for senior citizens, who make up about 9 per cent of the total population. 

Dr. Arun Jha, a dementia and Alzheimer’s expert, stated that Nepal has failed to provide specialized healthcare for the elderly due to a lack of 

infrastructure and proper legal frameworks.

Dr. Amrit Ghimire, a physician and president of the Senior Citizens Welfare Committee, added that few doctors are interested in studying elderly health issues.

Having conducted several health camps focused on senior citizens, Dr. Ghimire stressed that families should respect the elderly and hospitals must offer dedicated geriatric care by easing rigid regulations.

Currently, Patan Health Science Academy and BP Memorial College in Dharan are among the few institutions offering dedicated treatment for dementia and Alzheimer’s.

Dr. Jha also suggested that, alongside modern treatments, Nepal’s natural lifestyle and resources could play a key role in creating a positive environment for psychosocial counseling and elderly care.

Dr. Gaurishankar Lal Das, a chest specialist and also a senior citizen, emphasized, “It is completely false to consider that all senior citizens are difficult or burdensome.” He argued that many problems arise due to families and society being unable or unwilling to understand their challenges.

“If we don’t raise awareness about Alzheimer’s and dementia, or educate society about the sensitivity of these issues, it will lead to serious consequences in the coming decades — including significant social loss,” said Dr. Das.

Bhawana Pathak also shared that their family provides all the facilities her grandfather enjoys at home. “Many times, he gets angry, speaks harshly, and can even become violent,” she said. “But we consider all his behaviour as part of the human condition, not a burden.”

“We must accept his unusual behaviour and preferences. What he truly needs is our help and care, not command or control,” Bhawana added.