The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.
OVERVIEW
Most people can’t explain the difference between dementia and Alzheimer’s disease, and many use the terms interchangeably, but they are not the same thing.
- Dementia is not a single disease. It is an umbrella term — a way of describing a collection of symptoms that affect memory, thinking, behaviour, and the ability to perform daily activities. Think of it the way you think of the word “cancer”: just as cancer can take many forms (breast cancer, lung cancer, leukaemia), dementia can be caused by many different conditions.
- Alzheimer’s disease is the most common cause of dementia, accounting for 60–80% of all dementia cases globally. It is a specific, progressive brain disease in which abnormal proteins build up in the brain, damaging nerve cells and gradually destroying memory and cognitive function.
In simple terms: all people with Alzheimer’s have dementia, but not all people with dementia have Alzheimer’s.
One of the most important things to understand is that dementia is not an inevitable consequence of growing old. While age is the biggest risk factor (most diagnoses occur after age 65, and the risk roughly doubles every 7.7 years), significant memory loss, confusion, and personality change are never “just part of getting old.” If you notice these changes in yourself or a loved one, seek medical attention.
Do not dismiss early signs. Do not wait. And do not carry the weight of caring alone.
DEMENTIA IN SOUTH AFRICA
According to the World Alzheimer Report, approximately 187 000 South Africans are living with dementia, and nearly 75% of them are women. That number is expected to rise to 275 000 by 2030, and forecasts suggest it could exceed 680 000 by 2050.
As alarming as these projected numbers are, their accuracy has been questioned in light of several local studies. These have found that the number of South Africans living with dementia may be much higher than we think:
- A landmark community study in the Eastern Cape, conducted by researchers from the University of Cape Town, found a dementia prevalence of 11% among those aged 65 and older, significantly higher than the 4% previously estimated by the World Alzheimer Report. Of those who screened positive, 69.8% were women.
- A 2024 study in KwaZulu-Natal found an even higher rate: 13.4% prevalence of dementia among older adults in low-income communities, with those over 80 being 2.73 times more likely to develop dementia than younger participants.
- The latest Lancet Global Health research (2024) concludes that more than one million South Africans could be living with dementia in coming decades.
OTHER COMMON TYPES OF DEMENTIA
Beyond Alzheimer’s, other types include:
- Vascular dementia: caused by reduced blood flow to the brain, often following a stroke. This is particularly significant in South Africa, where high rates of untreated hypertension and stroke contribute to its prevalence. Research at the Groote Schuur Hospital Memory Clinic found vascular dementia to be more common in South African patients than in similar international settings.
- Lewy body dementia: caused by abnormal protein deposits that disrupt brain signals; often accompanied by hallucinations and movement problems.
- Frontotemporal dementia: affects personality and behaviour, often at a younger age than other types.
- Mixed dementia: where more than one type occurs simultaneously, which is more common than previously thought.
WHY WOMEN ARE MOST AFFECTED BY DEMENTIA
Women face a disproportionate burden of dementia, both as those who develop it and those who care for others living with it.
Globally, women experience higher rates of Alzheimer’s disease than men, even accounting for the fact that women live longer on average. The precise biological reasons remain under research, but hormonal changes (particularly the drop in oestrogen after menopause), differences in brain anatomy, and social determinants like lower access to education and higher rates of depression may all play a role.
At the same time, globally women provide 70% of care hours for people living with dementia. This is especially true in South Africa, where the absence of state support services means that the burden of care falls overwhelmingly to female family members.
UNDERSTANDING ALZEIMER’S DISEASE
In Alzheimer’s disease, two key abnormal structures develop in the brain: amyloid plaques (clumps of protein fragments between nerve cells) and neurofibrillary tangles (twisted fibres inside nerve cells). These structures disrupt communication between brain cells and eventually cause cell death.
The hippocampus (the brain’s centre for learning and memory) is typically the first region affected, which is why memory loss is usually the earliest sign.
Alzheimer’s progresses through stages:
- Early stage: Mild memory lapses, difficulty finding words, getting lost in familiar places. The person is usually still able to live independently.
- Middle stage: Increased memory loss, confusion, difficulty with daily tasks (paying bills, cooking), personality changes, wandering. This stage typically lasts the longest.
- Late stage: Full dependence on others for care, loss of ability to communicate verbally, vulnerability to infections. At this stage, the disease is life-limiting.
RISK FACTORS FOR DEMENTIA
WHAT YOU CAN DO: PROTECTING YOUR BRAIN HEALTH
The most encouraging finding in dementia science is also the most empowering: the choices you make today have a measurable impact on your brain health decades from now.
RECOGNISING THE WARNING SIGNS
Normal ageing looks like occasionally forgetting a name but remembering it later; or misplacing your keys.
Dementia warning signs include:
- Memory loss that disrupts daily life (asking the same questions repeatedly)
- Difficulty completing familiar tasks (cooking a meal, managing money)
- Confusion about time, dates, or places
- Problems with language, like struggling to find words or follow a conversation
- Changes in personality or mood, like increased anxiety, suspicion, or withdrawal
- Poor judgement, for example being easily scammed or neglecting hygiene
- Getting lost in familiar surroundings
- Withdrawing from social activities
If you notice these signs in yourself or a loved one, do not wait. Early diagnosis matters.
CARING FOR A LOVED ONE WITH DEMENTIA
79% of people living with dementia in South Africa are cared for at home, primarily by a spouse or adult child, and that caregiver is most often a woman. Families across the country are quietly carrying this weight, often without training, financial support, or respite.
SUPPORT RESOURCES
You do not have to navigate this alone. The following organisations provide support across South Africa: