In Imtiaz Ali's latest movie, Main Vaapas Aaunga, veteran actor Naseeruddin Shah delivers a poignant performance as Ishar Singh Grewal, a 95-year-old man whose fading memory becomes the emotional core of the story. While the film is rooted in themes of Partition, loss and identity, it also offers a powerful glimpse into the realities of dementia, a condition that affects millions of families worldwide. One of the most striking aspects of the film is how Ishar appears trapped between the past and the present. His distant memories remain vivid, often tinged with a post-stroke state of delirium, while recent events become increasingly difficult to grasp. For viewers, the portrayal may be heartbreaking. For caregivers of people living with dementia, however, it is also deeply familiar.

According to the World Health Organization (WHO), more than 55 million people globally live with dementia, with nearly 10 million new cases diagnosed every year. India is also witnessing a growing burden due to its ageing population. A report by the Alzheimer's and Related Disorders Society of India (ARDSI) estimates that over 8.8 million Indians may be living with dementia by 2036.

Experts say that while memory loss is often considered the hallmark symptom, dementia affects attention, communication, behaviour, sleep, orientation and emotional regulation, creating significant challenges not only for patients but also for the family members caring for them.

Dementia Is More Than Forgetfulness

"Dementia due to old age is a neurodegenerative process which occurs due to protein deposition in brain cells," explains Dr Trideep Choudhury, Consultant Psychiatrist, Fortis ADAYU. "As a result, the brain develops deficits in various domains, particularly the registration of new events and recall of recent memories. Patients often have difficulty remembering recent events but comparatively less difficulty recalling events from the remote past, meaning events that occurred before dementia set in."

This phenomenon is clearly reflected in Main Vaapas Aunga, where Ishar remains emotionally connected to decades-old memories while struggling with the present. According to the National Institute on Aging (NIA), Alzheimer's disease, the most common form of dementia, typically damages brain regions involved in memory formation first, which is why recent memories are often affected before older ones.

"Dementia is an umbrella term, and Alzheimer's dementia is the most common form of dementia," says Dr Choudhury. "Different dementias can also coexist, such as Alzheimer's dementia and vascular dementia due to stroke, which can make management challenging."

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Why Patients Sometimes Become Confused Or Aggressive

Many caregivers are often alarmed when a loved one suddenly becomes confused, agitated or unable to recognise familiar people. Dr Choudhury explains that dementia patients can experience episodes of delirium. "Dementia is a gradual or sudden decline of different brain functions in clear consciousness. However, dementia patients may sometimes go through a confusional state where they are not aware of the time, date, familiar people around them or even where they are."

He adds that dementia patients are particularly vulnerable to delirium when another illness develops. "People with dementia are prone to develop delirium when there is a concurrent physical problem like stroke, infection or fever. People with delirium may also show agitation and aggression at times." Delirium is common among older adults with dementia and is often triggered by infections, dehydration, medication changes or hospitalisation.

Why New Memories Become Difficult To Form

One of the biggest misconceptions about dementia is that patients simply "forget." The reality is more complex. "Dementia impacts a person's recall because the difficulty lies in poor registration of events," says Dr Choudhury.

"One of the important faculties impacted in dementia is attention. People find it difficult to sustain attention on relevant stimuli and get distracted very easily by irrelevant stimuli. As a result, they cannot register new information properly and recall is also poor." This explains why a person with dementia may repeatedly ask the same question, forget conversations that occurred minutes earlier or fail to remember recent visits from loved ones.

The Emotional Burden On Caregivers

While films often focus on the patient, experts say caregivers face enormous emotional and physical strain. Communication itself can become difficult, as Imtiaz Ali's movie clearly shows through the characters of Nirvair Grewal and his father, played by Diljit Dosanjh and Rajat Kapoor. "Communication with people with dementia and new-onset delirium is challenging," says Dr Choudhury. "Caregivers should try to orient the person to stimuli around them, such as reminding them of the time of day, encouraging conversations with familiar people and making access to their surroundings easier."

Simple environmental adjustments can make a significant difference. "Access to sunlight during the daytime, easy access to the washroom and familiar surroundings can help. Caregivers have to be patient and accepting and sometimes observe needs rather than react to every agitation. Many times, agitation is actually a help-seeking behaviour."

According to WHO, caregivers of people with dementia frequently experience higher rates of stress, depression and burnout compared with caregivers of individuals with other chronic illnesses.

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How Families Can Protect Their Own Mental Health

In Main Vaapas Aaunga, an aspect that gets very little attention, but may be foremost in the minds of caregivers of real-life dementia patients, is the mental health of the caregivers and those living with the patients. In a society like India, the caregiving burden often falls on children of ageing parents. Ishar's children in Main Vaapas Aaunga, for example, are themselves emotionally extended beyond their own means because of their father's situation, and this is often the case with caregivers in general.

Experts emphasise that caregiver wellbeing is an essential part of dementia care. "The best way to offer support is to form common self-help groups of dementia caregivers, acknowledge and accept caregiver burnout and learn from the treating team ways to increase skills to deal with patients with dementia," says Dr Choudhury. Support groups, respite care, counselling and caregiver education programmes have all been shown to improve quality of life and reduce caregiver distress.

Naseeruddin Shah's performance in Main Vaapas Aunga offers more than a cinematic portrayal of memory loss. It shines a light on the emotional complexity of dementia and the often-overlooked struggles of those caring for loved ones affected by the condition. As India's elderly population continues to grow, experts say understanding dementia, and supporting caregivers, will become increasingly important. The film serves as a reminder that behind every dementia diagnosis is not only a patient navigating a changing reality, but also a family learning how to navigate it alongside them.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.