Dementia is more than just forgetting things. It also affects how people think, reason, and go about their daily lives. Over time, it can even change how someone sees themselves.
A big question many people ask is: do people with dementia know they have it? Do they understand what’s happening to them?
To answer that, we need to understand something called “anosognosia.” This is a medical term that means a person doesn’t realize they have an illness. It’s not the same as denial. Denial is when someone doesn’t want to accept the truth. But anosognosia happens because of damage in the brain that stops a person from seeing their own condition.
This is common in people with dementia, especially those with Alzheimer’s disease, which is the most common type of dementia. But not everyone is affected in the same way. Whether someone knows they have dementia depends on how far the disease has progressed and which parts of the brain are damaged.
In the early stages of dementia, many people do notice the changes. They may find it harder to remember things, speak clearly, or do everyday tasks. This can make them feel sad, anxious, or even depressed. In fact, studies show that people who are aware of their memory problems often feel more emotional distress.
But as the disease gets worse, awareness often fades. The brain areas that help us reflect on ourselves and judge situations may stop working properly. When that happens, people with dementia may not realize they are forgetting things or acting differently.
In the later stages of dementia, many people are not aware of their condition at all. For some, this might be a good thing—it saves them from the sadness of knowing they are getting worse. But for family members and caregivers, it can make things harder. They have to make important decisions for someone who doesn’t understand what is going on.
Scientists have been looking for ways to help people with dementia become more aware. Some personalized therapies have shown promise. These include activities that are tailored to the person’s interests and memories. They can help people feel more connected and may even improve awareness.
Still, making someone more aware isn’t always the best choice. If it causes stress or sadness, it might be better to focus on comfort instead. Every person is different, and what helps one person might upset another.
In the end, there is no simple answer to whether people with dementia know they have it. Awareness can come and go. It depends on many things, like the type of dementia, the stage of the disease, and the person’s brain.
For caregivers and loved ones, it’s important to understand that this awareness can change over time. Being patient and kind—and adjusting care to match the person’s needs—is key. Supporting someone with dementia means respecting their experience, helping them feel safe, and doing whatever we can to protect their dignity and well-being.
If you care about dementia, please read studies about low choline intake linked to higher dementia risk, and how eating nuts can affect your cognitive ability.
For more information about brain health, please see recent studies that blueberry supplements may prevent cognitive decline, and results showing higher magnesium intake could help benefit brain health.
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