Advertisement expert Arunita Sen is 36 years old. She has decided not to have children. Not because she does not want them but because she already has two—her parents.
Her mother is 65 and has Alzheimer’s.
Her father is 75 and is her mother’s primary caregiver in Kolkata. And Arunita, from another city, manages what she can from a distance. AirTags on her mother’s wrist, sensor cameras in the entire house and a flight booked every few weeks to Kolkata. “My parents are my children now,” she told News18. “I just did not plan for it to happen this soon.”
Her mother’s forgetting did not arrive suddenly. It crept in over time. A word that would not come, a familiar face that took a second too long to place or mixing the name of vegetables. “She would call ladyfinger a bitter melon and bitter melon something else. My father noted a pattern. He told me she cooks the same style of fish every day. Otherwise, she has been a housewife and had her own way of cooking fish in 100 styles.”
By the time they reached a neurologist, the disease had been progressing silently for years. “She doesn’t recognise my face anymore. I am her only child,” Arunita said, holding her tears back.
Things To Notice
The first thing to notice here is that Alzheimer’s does not begin when the symptoms appear. It begins decades before. The brain changes that eventually lead to memory loss—the accumulation of amyloid plaques between nerve cells, the twisting of tau proteins inside them—can start as early as by the age of 45. By the time a person forgets where they are, the disease has often had a 20-year head start.
The second thing to understand is what Alzheimer’s actually does. Our brain has 86 billion nerve cells, communicating constantly through connections called synapses. That communication is what allows you to remember, to speak, to recognise, and to navigate the world. Alzheimer’s systematically destroys those connections. Memory goes first; recent memory usually before long-term. Then language, then recognition and then the ability to manage daily life. In its final stages, the brain can no longer tell the body how to swallow or breathe. There is currently no cure.
Drugs Lecanemab and Donanemab have been approved by US FDA. Eisai and Biogen’s Lecanemab in studies showed that after 18 months of treatment, Lecanemab slowed cognitive decline by 27 per cent compared with placebo in a trial of nearly 1,800 patients with mild cognitive impairment or early Alzheimer’s. “These drugs have been approved abroad and I believe they are close to enter India. A few of my patients are already importing and using them. These drugs are promising and effective, however, in the initial stages only,” explained Dr MV Padma Srivastava, head, neurology at Paras Health, Gurugram.
Eli Lilly’s Donanemab showed in a late-stage clinical trial about 35 per cent lower risk of progression of the disease compared to placebo. It is administered as 30-minute infusions every four weeks, making it more convenient than Lecanemab.
The third thing—and this is what new science is urgently telling us—is that women are disproportionately at risk. Nearly two-thirds of all Alzheimer’s patients globally are women.
Alzheimer’s is often called a women’s disease and the numbers bear that out. Nearly two-thirds of all Alzheimer’s patients globally are women. A 45-year-old woman has a 1 in 5 lifetime risk of developing the disease—twice that of a man her age.
A landmark study published in March 2026 in the Journal of Clinical Investigation argues that this disparity is not simply because women live longer. It is biological. The hormonal transition of menopause—the sharp drop in estrogen, a hormone that actively protects the brain—may be the moment when Alzheimer’s risk begins accelerating in women. Midlife, the study argues, is the front line of Alzheimer’s prevention.
What Happens To Women In Midlife?
The research is consistent—what you do in your 40s and 50s shapes your brain in your 70s. “Cardiovascular health, sleep, stress, physical activity and cognitive engagement are not lifestyle choices in midlife. They are brain protection strategies. High blood pressure, uncontrolled diabetes, obesity and chronic sleep deprivation in midlife are all independently linked to higher Alzheimer’s risk later,” Dr Manjari Tripathi, head of department, neurology at AllMS, New Delhi, said.
There is another layer to this that no study fully captures. “When a man shows signs of memory loss, it is his wife, his daughter, his daughter-in-law who notices, who worries, who books the appointment and walks him through the hospital door. But when a woman forgets—she is a mother, a wife, a homemaker. Her forgetfulness is explained away as distraction, as exhaustion, as the natural cost of carrying an entire household. She is the caregiver. Nobody is watching out for her. And so, her Alzheimer’s is detected late; not because the signs were not there, but because no one thought to look,” Tripathi mentioned.
Overall, for women specifically, the perimenopausal years demand closer attention, not just to hot flashes and irregular cycles, but to mood changes, memory slips and cognitive fatigue that are too easily dismissed as stress. “This is the decade to build the habits, have the conversations, and ask the questions that could matter more than any drug ever will.”
In short, India has 100 million women in the 40-55 age group. Most of them have never been told that the brain fog they experience during perimenopause deserves medical attention. Most of them will never speak to a neurologist until a crisis forces the conversation.
Arunita’s mother was not told either.
Pay attention in midlife when your estrogen level start falling. Talk to your doctor about cognitive symptoms you have been dismissing, especially if there is a history of Alzheimer’s in your family, or if you recall an elderly relative who lost their memory but were never told exactly why.
The window to act is open, but it will not stay open forever.
