More forgetfulness, a shift in personality, the same story told again and again — when you first notice small changes like these, confusion and worry hit your family all at once. You are not alone in this.
Understanding the condition
It's an illness, not aging
Dementia is an umbrella term for a group of conditions in which cognitive function progressively declines. It is neither "simple forgetfulness" nor "a personality problem" — it reflects genuine pathological change in the brain.
More than 55 million people worldwide
The World Health Organization's (WHO) estimate of the number of people living with dementia.
Alzheimer's disease is reported to account for the largest share.
"Your loved one hasn't become someone else — their brain has become ill."
Early signs — 10 checkpoints
There's no need to panic if only one or two of these apply. But if three or more persist for six months or longer, seeing a doctor for evaluation is recommended.
Asks the same question repeatedly
Forgets recent events but recalls the distant past clearly
Gets lost on a familiar route
Increasingly struggles to find words or follow conversation
Starts putting everyday items in unusual places
Impaired judgment — impulsive purchases or buying the same item repeatedly
Personality changes — more suspicious, more irritable, or more withdrawn
Loses interest in things and becomes reluctant to go out
Loses track of time (gets the date or season wrong)
Can no longer operate familiar appliances (remote control, stove, etc.)
4 major types
Dementia isn't a single disease. The type shapes the direction of both treatment and care.
Begins with hippocampal atrophy; recent memory impairment is prominent. Progression is relatively gradual.
Related to cerebrovascular damage, often worsening in steps. Can co-occur with AD.
Marked by visual hallucinations, Parkinson-like symptoms, and fluctuating cognition. Tends to be highly sensitive to antipsychotic medications.
Behavioral and personality changes appear early, while memory is relatively preserved. Often begins before age 65.
From worry to diagnosis
Getting an early diagnosis matters for two reasons: it leads to more targeted treatment, and it ensures treatable causes aren't overlooked.
- 1. Visit a memory clinic, neurology, or geriatric medicine department
It helps to write down specific changes from the past six months beforehand.
- 2. Cognitive screening tests
Assessment scales such as MMSE or MoCA, plus interviews with family (e.g. AD8).
- 3. Imaging
MRI (structural), and PET (metabolism, amyloid, tau) if needed.
- 4. Blood tests to rule out treatable causes
Vitamin B12, thyroid function, electrolyte imbalances, and similar.
- 5. Neuropsychological testing where needed
Especially important in early-stage or atypical cases.
Day-to-day care
4 keys to being present with them
How you connect matters more than being factually "correct."
① Speak slowly
Give them time to respond. Rushing tends to cause more confusion, not less.
② Don't correct them
Don't argue over whether it's Tuesday or Wednesday. Meet them in the feeling of the moment instead.
③ Make eye contact
Crouch or sit to meet their eyes, and hold a hand if it feels right. Reassurance lands better than logic.
④ Keep it short, and repeat the same words
One thing at a time. If they don't catch it, repeat it exactly rather than rephrasing.
They may forget what you said, but they remember the warmth in your voice.
Home safety checklist
Making the home a safer place is one of the earliest steps you can take.
Eating and swallowing
Eating difficulties are among the most overlooked yet important issues from the middle to later stages of dementia.
Monitor weight
Weigh monthly. A loss of 5% or more over a year warrants an early conversation with a doctor.
Food texture
Favor soft, easy-to-swallow foods. Move to pureed textures in later stages, using a thickener when needed.
Mealtime environment
Keep it calm and quiet, and don't rush. Serving one dish at a time reduces confusion.
Signs of swallowing trouble
Persistent coughing, more drooling, a "wet"-sounding voice after eating — seek a swallowing evaluation early.
Nutritionally, aim for adequate protein, vitamin D, and omega-3s, along with roughly 1.5 liters of fluids a day.
Working with behavioral and psychological symptoms (BPSD)
BPSD refers to the cluster of behavioral and psychological symptoms that accompany dementia — agitation, wandering, hallucinations, delusions, apathy. These often appear before the core cognitive symptoms and can be the most demanding part for families.
① Look for the trigger
Pain, constipation, infection, dehydration, medication side effects — the cause is often something easy to miss.
② Adjust the environment
Noise, harsh lighting, unfamiliar faces, and frequent changes in caregiver can all worsen symptoms.
③ Use connection
A hug, a held hand, humming a familiar song — these can work better than trying to reason it out.
④ Use medication carefully
People with DLB are extremely sensitive to antipsychotics. Prioritize non-drug approaches first.
Preparing for wandering
Many people with dementia become lost or disoriented at some point in their journey. Both prevention and preparedness matter.
For prevention
- · Use a GPS tracking device, or an ID tag with name and contact information
- · Sew an emergency contact tag into the inside of clothing
- · Register with your local watch network or missing-person alert service
- · Stay close during higher-risk hours (afternoon to evening)
What to include on an emergency card
Name, sex, date of birth / diagnosis (e.g. Alzheimer's disease) / allergies and current medications / primary caregiver and emergency contact / regular doctor and medical facility
If they go missing: Don't hesitate — contact the police immediately. There's no need to wait 24 hours to see what happens. If you're registered with your local watch network, that registration can help the search.
Choosing treatment and care
4 pillars of comprehensive care
There's no single fix for dementia care. Supporting all four areas at once is what keeps daily life stable.
① Medical evaluation
Regular visits to neurology or geriatric medicine, and management of any coexisting conditions.
② Medication management
Cholinesterase inhibitors, memantine, and similar medications, taken according to the doctor's instructions.
③ Non-drug care
Cognitive stimulation, exercise, music, gardening — everyday activities that engage the mind.
④ Care for family and caregivers
Relationships, daily rhythm, rest, and making use of community resources and support groups.
What to know about medications
What's available
Cholinesterase inhibitors (donepezil, rivastigmine, and others) are used for mild-to-moderate AD, memantine for moderate-to-severe AD. Anti-amyloid-beta antibody therapies are approved only for a limited early-stage AD population.
The right choice depends on the type
People with DLB are highly sensitive to antipsychotics, and using them incorrectly can trigger severe extrapyramidal symptoms. Cholinesterase inhibitors can worsen agitation in FTD. Choosing the right medication starts with identifying the type.
Set realistic expectations
Medication is meant to slow progression and ease BPSD — not to "cure" the condition. Starting low and adjusting slowly is the standard approach.
Important: Any change or discontinuation of medication must be made under a specialist's guidance. Please don't adjust dosages on your own as a family.
Non-drug care and nutrition management
Beyond medication, the daily rhythm of life is the true foundation.
Looking through photo albums, reading the newspaper, playing cards, listening to music
Walks, gentle movement like tai chi, light strength training
Sufficient light during the day, to help ease evening agitation ("sundowning")
Pets, gardening, contact with neighbors, and other social ties
For diet, a long-term pattern like the Mediterranean or MIND diet is a good foundation; if weight loss occurs, aim for roughly 1.0–1.2g of protein per kilogram of body weight, along with about 1.5 liters of fluids a day. Dehydration can worsen delirium and BPSD, so it deserves attention. Signs like difficulty eating or persistent coughing while eating should take priority over "eating healthily."
Nutritional support
What Chienomoto can do
Chienomoto is a functional food designed to support brain health. In dementia care, it's positioned as nutritional support aimed at "helping the brain function more smoothly." It's often used to support the mood swings, sleep issues, and behavioral changes that come with the behavioral and psychological symptoms of dementia (BPSD).
Stabilizing
neuronal membranes
Supporting
energy metabolism
Improving brain
network efficiency
Many families describe small but meaningful shifts in day-to-day life — more time spent calm and settled, a bit more conversation returning. For an older person, small recoveries like these carry real weight in daily life. And it's rarely just about the individual — often, the whole family's daily rhythm gradually settles too.
An important note: Chienomoto is a functional food, not a medicine. It is not a substitute for medications prescribed by a doctor, such as donepezil or memantine. Continue prescribed medication exactly as directed, and use Chienomoto only as a supplementary form of nutritional support. Please always consult your physician about whether and how to incorporate it.
To families
5 common questions
Q. Isn't this just normal aging?
A. Ordinary aging doesn't cause lasting impact on daily functioning. If three or more signs persist for six months or longer, a medical evaluation is recommended.
Q. Can dementia be cured?
A. Most types cannot be fully reversed, but progression can be slowed and symptoms eased. The earlier the intervention, the greater the benefit tends to be.
Q. Should we tell them the diagnosis?
A. If they're still able to understand, sharing it gently can help them engage with treatment. Once symptoms have progressed, there's no need to keep repeating or emphasizing it.
Q. They no longer recognize me. What should I do?
A. Don't force them to "remember." Their feeling safe beside you matters more than whether they "remember" who you are.
Q. I'm not sure I can keep doing this.
A. You need moments to breathe, people who support you, and a doctor of your own too. Taking care of yourself is what lets you truly take care of them.
A word to families
You're already doing more than enough.
Dementia brings more than a loss of cognitive function — it changes the shape of a relationship. What you're doing now is loving someone you cherish, growing older, in an entirely new way.
They may no longer respond to you the way they once did, and that can hurt. And yet, the person beside you is still the same one who always loved you.
You, too, deserve to be seen and cared for.
Please allow yourself to feel tired, and to feel sad.
Seeing them is where change begins.
Standing beside them is, in itself, already a form of care.
4 things you can do today
Book a specialist evaluation
Memory clinic, neurology, or geriatric medicine. Organize the past six months of changes beforehand.
Build a home safety checklist
Medications, sharp objects, gas, non-slip measures, wandering precautions — work through them one at a time.
Find someone who can give you a break
Even one day a week, lean on other family members or a professional caregiver. That's not laziness — it's what lets you keep going.
Connect with a family or support group
Online communities, family classes at medical facilities, local elder support centers. You don't have to carry this alone.
Caregiving is more like a marathon. Pacing yourself matters more than speed.
References (click to expand)
- World Health Organization. Global status report on the public health response to dementia, 2021.
- Lane CA, Hardy J, Schott JM. Alzheimer's disease. Nature Reviews Disease Primers, 2018.
- Volkert D, et al. ESPEN guideline on clinical nutrition and hydration in geriatrics with dementia. Clinical Nutrition, 2024.
- Kales HC, Gitlin LN, Lyketsos CG. Assessment and management of behavioral and psychological symptoms of dementia (BPSD). BMJ, 2015.
- Cummings J, Lee G, Ritter A, et al. Alzheimer's disease drug development pipeline. Alzheimer's & Dementia, 2024.
Before you use this guide: This guide is a public educational resource for families and is not medical diagnosis or treatment advice. Please always consult a physician about your family's specific situation. Chienomoto is a functional food and is not a substitute for medical treatment.