The Long Goodbye: The Rise of Dementia

Despite the global rise in dementia, people living with the condition should continue to enjoy the same human rights as everyone else — including the rights to dignity, autonomy, and participation in decisions about their lives. Credit: Shutterstock

By Joseph Chamie
PORTLAND, USA, Apr 15 2025 (IPS)

As the world’s population of 8.2 billion people increases in size and becomes older due to demographic ageing, the number of people experiencing the long goodbye, or dementia, is rapidly rising.

In 2025, the number of people living with dementia worldwide is estimated to be approximately 60 million. That global number is expected to more than double by 2050, reaching approximately 153 million. That rise presents considerable challenges to social care and health systems as well as families over the coming decades. Again, dementia is rising largely due to world population’s growth and demographic ageing (Table 1).

By mid-century, the world’s population is expected to gain an additional 1.5 billion people, increasing to 9.7 billion with its median age increasing from 31 years to 36 years. Also over the next twenty-five years, people are expected to live longer with the world’s life expectancy at birth projected to increase from approximately 73 years to 77 years.

Over that same twenty-five-year time period, the world’s population is expected to experience demographic ageing. The proportion of the world’s population aged 65 years or older, for example, is projected to increase from 10% to 16% and the proportion aged 80 years or older is expected to more than double from 2% to 5%.

Dementia is the leading cause of disability and dependency among the elderly. Without individuals, families, communities and governments earnestly addressing and implementing the modifiable risk factors for dementia, the numbers of men and women living with dementia are expected to increase significantly throughout the 21st century.

Despite the expected worldwide rise in dementia, people living with the syndrome should continue to have the same human rights as other members of a population. Among those rights include the right to dignity, autonomy and participation in decision making about their lives.

Unfortunately, however, it is often the case that people living with dementia are denied the basic human rights and freedoms available to other members of a society.

It is also important for the general public, business leaders, healthcare providers and government officials to recognize and understand that dementia is NOT a part of the normal ageing process (Table 2).

Dementia is a syndrome caused by diseases that affect the brain. The condition is not just about memory loss but also affects thinking, behavior and emotion.

Dementia is a general term that results from a variety of diseases and injuries that affect the brain and affect memory, thinking and the ability to perform daily activities. Although many people with dementia can live reasonably well, the condition tends to get notably worse over time and is a significant cause of death among older adults.

Dementia may develop after a stroke or in the context of certain infections such as HIV; as a result of harmful use of alcohol; repetitive physical injuries to the brain; and nutritional deficiencies.

While currently there’s no cure for the long goodbye, various services and support are needed for people living with dementia and their caregivers.

Also, it is NOT the case that nothing can be done to prevent or reduce one’s chances of experiencing the long goodbye. The Lancet Commission on Dementia estimated that approximately 45% of all dementia cases worldwide could be prevented or delayed by addressing 14 modifiable risk factors.

Among the modifiable risk factors are alcohol abuse, smoking, obesity, physical inactivity, social isolation, hearing loss, lower levels of education and vision loss. Other modifiable risk factors for dementia include diabetes, high blood pressure, air pollution, brain injury, depression and high LDL cholesterol (Table 3).

Dementia mainly affects the elderly and is generally more common among women than men. Women tend to live longer than men, thereby increasing their risk of developing dementia. In addition, biological reasons differing between men and women are believed to contribute to the differences in the chances of having dementia.

Surveys indicate that nearly 80% of the general public are concerned about developing dementia at some point in their lives. However, it is important to recognize that not everyone will experience dementia as they age.

Alzheimer’s disease is the most common form of dementia, accounting for approximately 60% to 70% of the cases. Also, the large majority of those with Alzheimer’s disease are estimated to be women. Other types of dementia include vascular dementia, Lewy body dementia that may occur with Parkinson’s disease, frontotemporal dementia and mixed dementia.

The Lancet Commission on Dementia estimated that approximately 45% of all dementia cases worldwide could be prevented or delayed by addressing 14 modifiable risk factors

While Alzheimer’s disease is not a part of normal ageing, the chances of getting the disease rises as one grows older. Also, having a family history of Alzheimer’s increases one’s risk of contracting the disease. Some preliminary research suggests that antivirals, antibiotics, vaccines and anti-inflammatory drugs could possibly help to treat, prevent or reduce the risk of dementia.

Among the common symptoms of dementia are: confusion; memory loss; needing help with daily tasks; problems with language and understanding; changes in personality including unusually anxious or irritable; getting lost when walking or driving; and having trouble following a conversation.

Although consciousness is not affected by dementia, the decline in cognitive function is common and may also be accompanied by changes in emotional control. In addition, sometimes changes in mood and behavior may precede the loss of memory.

In the early stages, the symptoms of dementia may be small, irregular and subtle. Over time, however, the symptoms tend to get worse and become more noticeable. Most people with dementia end up needing others, especially family members, to provide them assistance for their daily activities.

The various consequences of the long goodbye are considerable, impacting individuals, families, local communities and societies. The general lack of awareness and understanding of dementia by the public and government officials delays timely diagnosis and the provision of appropriate care as well as taking preventive actions.

If an individual is experiencing cognitive changes, that person should seek medical evaluation. It is also important to understand that many people with dementia can still live well.

However, it is estimated that up to three quarters of those living with dementia worldwide have not received a diagnosis. Moreover, those individuals that have a dementia diagnosis tend to be reluctant to indicate their condition because of the stigma associated with it. Also, surveys have estimated that approximately one-third of care givers worldwide report that they have hidden the diagnosis of dementia of a family member.

Besides dementia leading to dependency for the individual having the syndrome, it typically substantially increases the emotional burdens and health consequences on caregivers. Moreover, dementia often results in considerable economic costs relating to the provision of needed healthcare services.

The highest levels of dementia around 2024 are typically reported among the older populations of more developed countries. Finland and the United Kingdom have the highest reported rates of dementia of 55 and 43 per 100,000 population, respectively. The proportion of those aged 65 years or older having dementia is about 7% in both countries. In eighth place is the United States with a rate of dementia of 33 per 100,000 population, with approximately 10% of its population aged 65 years or older having dementia (Figure 1).

While dementia is rapidly rising worldwide, it is important for people to understand that dementia is NOT a normal part of ageing. Dementia is a syndrome caused by diseases that affect the brain and a number of things can be done to prevent or reduce an individual’s chances of getting the long goodbye.

In brief, staying mentally, physically and socially active, not smoking, eating a balanced healthy diet, keeping alcohol consumption within recommended limits, reducing hearing and vision loss, and keeping blood pressure and cholesterol levels in check contribute to maintaining healthy brains as men and women age.

In conclusion, the continuing growth of the world’s population and demographic ageing during the 21st century are contributing to the expected rise of dementia that present considerable challenges to social care and health systems as well as families. If individuals, families, communities and governments earnestly address dementia’s various modifiable risk factors, their collective efforts can contribute significantly to reducing the worldwide rise of the long goodbye.

Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division and author of numerous publications on population issues, including his recent book, “Population Levels, Trends, and Differentials”.