The Mind We Don’t Think About Until We Have To
Driving in the car today, listening to the ABC News, I heard a headline that stayed with me long after the segment ended: Australians have “startlingly” low awareness of controllable dementia risk factors.
The ABC report shared statistics that felt quietly confronting. Only 16% of Australian women recognise that dementia is the leading cause of death for women in Australia. Even more striking, research suggests that nearly half of dementia cases could potentially be delayed or prevented by addressing modifiable risk factors across the lifespan, as reported by the ABC News (Australian Broadcasting Corporation, 2026) and originally identified in the Lancet Commission on Dementia Prevention, Intervention and Care (Livingston et al., 2020).
I sat with that for a moment…
As a woman, I thought about the female people who make up my world - my mother, my sisters, my sister-in-law, my aunty, close friends, colleagues. It made me pause and ask a simple but uncomfortable question: how is it possible that something so significant remains so quietly known amongst us all?
And from a psychological perspective, I founded myself wondering why cognitive decline often sits at the edge of awareness rather than in our everyday health conversations. Perhaps because it feels distant. Or perhaps because it asks us to imagine a version of ourselves we do not yet recognise, nor want to ever imagine.
What we mean when we say “dementia”
Dementia is not a single disease. It is an umbrella term describing a group of symptoms that affect memory, thinking, behaviour, and the ability to carry out everyday activities.
Clinically, the DSM-5-TR (American Psychiatric Association, 2022) classifies dementia as Major Neurocognitive Disorder - a condition in which cognitive decline significantly interferes with independence and daily functioning.
But beyond the definition, dementia is experienced in much more human terms: forgetting familiar words, losing the thread of conversations, struggling with orientation, or gradually needing support with once-routine tasks.
It is not only memory that changes, but the architecture of everyday life. And it doesn’t just affect the person, but their entire world around them.
The brain, identity, and the frontal lobe
One of the most psychologically confronting aspects of dementia is that it does not affect the brain evenly.
The frontal lobe, particularly the prefrontal cortex, plays a central role in what we often think of as “self”: decision-making, judgement, emotional regulation, planning, social behaviour, and aspects of personality.
When these areas are impacted, families may notice changes that feel deeply personal. Not just forgetfulness, but shifts in temperament, initiative, empathy, or emotional responsiveness.
From a psychological standpoint, this is often where the grief begins long before physical dependency sets in. What we might describe as ambiguous loss. The person is still present, yet something essential feels altered or slipping.
Why this matters psychologically
Having witnessed close relatives and family friends across the lifespan experience dementia, I have seen how it does not only affect cognition, but relationships, attachment patterns, and the emotional landscape of an entire family system.
There is often a slow recalibration that happens. Roles shift, communication changes, and family members begin to hold both presence and loss at the same time.
This is why awareness matters. Not to create fear, but to support earlier understanding, earlier intervention, and more compassionate preparation.
What we can influence
One of the most important shifts in dementia research over the past decade is the growing evidence that brain health is not entirely fixed.
Large-scale research, including the Lancet Commission on Dementia Prevention, Intervention and Care (Livingston et al., 2020), has identified multiple modifiable risk factors across the lifespan, including physical inactivity, smoking, excessive alcohol use, hypertension, diabetes, hearing loss, social isolation, depression, and low cognitive engagement.
The World Health Organization similarly emphasises that lifestyle and cardiovascular health play a meaningful role in reducing dementia risk (World Health Organization, 2023).
These are not dramatic interventions. They are cumulative ones.
Walking more often. Staying socially connected. Managing stress. Prioritising sleep. Supporting cardiovascular health. Protecting hearing. Continuing to learn.
Small things, repeated over time.
A quieter reflection
What strikes me most is how easy it is to invest energy into visible care, appearance, productivity, external demands, while the brain quietly carries everything we are.
Our memories. Our relationships. Our ability to think, to feel, to choose, to connect.
And yet it is often the least consciously cared-for part of ourselves.
Dementia forces us to confront something uncomfortable: that identity is deeply tied to brain health, and brain health is shaped across decades, not moments.
If reading this raises questions for you about your own cognitive or mental health, it may be worth exploring further support or research opportunities.
In Sydney, the Brain and Mind Centre at the University of Sydney is actively involved in research on brain health, ageing, and mental health across the lifespan. Participating in research can be one way of contributing to a broader understanding of prevention, early detection, and support pathways for future generations.
While these statistics may not feel immediately relevant to everyone, I hope they linger in a quiet way.
Not as fear, but as awareness.
Because cognitive health is not only about preventing decline. It is about preserving the parts of us that allow us to recognise ourselves, our memories, our relationships, our sense of continuity, and our connection to others.
And perhaps that is the real conversation worth having a little earlier in life.
Written by Victoria MulcahyProvisional Psychologist
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). https://doi.org/10.1176/appi.books.9780890425787
Australian Broadcasting Corporation. (2026, May 29). Australians have “startlingly” low awareness of controllable dementia risk factors. ABC News. https://www.abc.net.au/news/2026-05-29/dementia-alzheimers-risk-factors-women/106731056
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6
World Health Organization. (2023). Risk reduction of cognitive decline and dementia: WHO guidelines. World Health Organization. https://www.who.int/publications
Australian Institute of Health and Welfare. (2024). Dementia in Australia. Australian Government. https://www.aihw.gov.au/reports/dementia/dementia-in-aus
