The Anatomy of Losing Her

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11 Sep 2026

12 Min Read

Adeline Chia Yoke Yin (Academic Contributor), The Taylor’s Team (Editor)

IN THIS ARTICLE

A note before you read: ‘Her’ is an illustrative composite created from experiences commonly shared by Malaysian families living with dementia, and she is not any one real person; names and details are fictional. This article discusses dementia, and if someone you love is affected, support services are listed at the end.

She is right there in the same house, in the same kitchen, in the same seat at the reunion dinner table, and there will be a long goodbye before you finally ‘lose’ her. Alzheimer’s disease, one of the most common types of dementia, accounts for an estimated 60 to 70 per cent of cases worldwide according to the World Health Organisation, and that goodbye rarely arrives all at once. It is lost piece by piece, day by day you can number, taking one thing at a time until the person you love is no longer the person you know.

The Start of the Long Goodbye

A grandmother hands a red ang pow packet to her grandson across the reunion dinner table.
Day 1Chinese New Year

She asks how your examination results went, and you tell her as she beams and presses an ang pow into your hand, refusing to let go until you promise to eat properly. Ten minutes later, she asks the same question again. You answer her again, and nobody around the table thinks much of it.

111 days later
An elderly woman adds a pinch of salt to a pot of lotus root soup simmering on the stove.
Day 112

She salts the lotus root soup twice, using a recipe she has cooked since before your mother was born, and she covers the pot quickly before anyone can notice, because she has always been proud like that.

127 days later
An elderly woman speaks into a mobile phone at home as a family member approaches from behind.
Day 239

A man claiming to be from the bank telephones one afternoon and speaks very politely, and she is reading out an OTP code when you walk in and take the phone from her ear. She stays furious all evening, because she raised four children on a hawker stall’s margins and could smell a cheat at fifty paces. Alzheimer’s has taken her verification system, not her common sense.

21 days later
A family sits with a doctor in a consultation room during an assessment for Alzheimer’s disease.
Day 260The diagnosis

The family finally brings her to see a doctor, and she sits through the questions and the little tests with the patient, slightly amused air of someone humouring a fuss she does not think is necessary. The results come back a week later. Alzheimer’s disease, the doctor says, and the word lands in the room the way words like that do, quietly, and then all at once.

45 days later
A family gathered and laughing around a birthday cake, the grandmother at the centre of the table.
Day 305Her 60th birthday

The family gathers on a Sunday afternoon with a cake from the bakery she used to disapprove of, and she is, for one whole afternoon, entirely herself. She remembers every cousin’s name, teases your uncle about his second helping of noodles, and tells the story of the year the hawker stall flooded with such precision that everyone puts down their chopsticks to listen. Afterwards your mother whispers that perhaps the doctors were wrong, and for a few weeks the whole family allows itself to believe it.

95 days later
An elderly woman stands still at a roadside junction holding shopping bags as a neighbour walks towards her.
Day 400

She gets lost on the walk home from the pasar she has visited for thirty years, and a neighbour eventually finds her at a junction she has crossed ten thousand times, holding bags of ikan bilis and staring at the road as though it were new.

112 days later
An elderly woman at a wedding banquet table gestures towards a younger relative as family members look on.
Day 512Your cousin’s wedding dinner

The extended family is gathered under one ballroom chandelier, and she looks straight at you across the round table and calls you by your mother’s name, then by your uncle’s. An aunt quietly corrects her twice before your mother reaches across and takes her hand, and when she stops trying altogether she switches into Hokkien, and the sentences come more easily than they have all evening.

176 days later
A young man sits beside his grandmother on a roadside bench, the two of them looking at each other.
Day 688

She looks at you with the polite caution of a person who suspects she should know you but cannot place you, and something in that look hurts more than everything that came before it. You introduce yourself anyway, and she offers you the same laugh she has always had, because her manners have survived everything the disease has taken so far.

13 days later
An elderly woman sits alone in a quiet living room, looking towards the window.
Day 701

She no longer knows your name, but when you take her hand she holds on firmly, the way she used to pull you across the road, and when your uncle plays her old Teresa Teng record, her fingers find the rhythm on the tabletop before anyone notices. She still reaches for her tea at the same hour every afternoon, still frowns when the newsreader speaks too quickly, and still taps the table twice when your uncle pours her tea, in the old silent courtesy of thank you.

The small ceremonies of who she is have outlasted the filing cabinet of facts.

Nobody marks the exact day anymore.
The family has stopped counting.
An elderly woman rests in a care bed at home, surrounded by framed family photographs.
Day 1500and beyond

She no longer speaks, no longer walks unaided, no longer reaches for her tea at the old hour. But she is still breathing, still here in the room with you, her chest rising and falling in the quiet the way it has every day since the beginning. Alzheimer’s has taken almost everything it came for.

Reading a brain that early is the work of neuroscientists, and it is what a Bachelor of Applied Health Sciences is built to teach.

The Quiet Decays

The changes we notice most clearly today may have been preceded by a much longer, quieter process. Some Alzheimer’s-related biological changes can begin a decade or more before noticeable symptoms appear, developing gradually while everyone around her still sees her as sharp and well.

 

Long before the repeated question, the salted soup or the scam call, changes may already have been taking place in her brain without obvious signs. There may have been nothing for her family to notice, and nothing they could have known to look for. That is part of what makes Alzheimer’s so difficult to recognise in its earliest stages: by the time the changes become visible, the underlying process may already have been developing for years.

 

Because the disease runs ahead of its symptoms for years, finding it early changes what families can do: they can plan care, manage the conditions that accelerate decline, and access support while it still makes a difference. Reaching that diagnosis typically involves cognitive assessments, brain imaging and, increasingly, blood-based biomarker tests, all interpreted by trained professionals.

Grandma walking under the sunset

The Malaysian numbers show why this matters. Around one in ten Malaysians aged 60 and above lives with dementia, according to the National Health and Morbidity Survey 2025. That translates to roughly 260,000 people, in a country that became an ageing society in 2021 and is projected to move towards aged-nation status within the next two decades, according to Department of Statistics Malaysia projections.

 

For many families, the impact extends well beyond the person with dementia. Much of the daily care falls on family members, and one Malaysian study found that family caregivers reported being engaged in or responsible for care for an average of about 18 hours a day in later stages of the disease. Other Malaysian research has also found that around seven in ten dementia caregivers are women, most commonly daughters.

 

There is genuine reason for hope, too. Research suggests that up to around 45% of dementia risk is associated with potentially modifiable factors across the life course. These include hearing loss, depression, hypertension, diabetes and physical inactivity. This means that prevention and risk reduction remain important, even as research continues to advance our understanding of the disease. The 2024 Lancet Commission on dementia and updated guidance from the WHO support the importance of addressing these modifiable risk factors.

The Science of the Brain

The study of the brain is the study of one of the most important organs behind this story. Alzheimer’s is one of the core diseases neuroscientists spend their careers on, because so much of it still needs explaining.

 

They look at how amyloid plaques (sticky clumps of protein that build up between brain cells) and tau tangles (twisted fibres that form inside brain cells) build up years before symptoms appear, how those changes show up on a brain scan or in a blood sample as early as ten to fifteen years before the first noticeable memory lapse, and how a diagnosis that once relied on guesswork can now be confirmed with far more precision than before. Neuroscientists work alongside geneticists who study family risk, radiologists who read the imaging, and clinicians who turn all of it into a plan a family can actually use.

 

Blood tests that can detect Alzheimer’s-related biological changes are now moving from research settings into clinical practice, making earlier detection increasingly possible. One of the more surprising signs researchers are investigating is a change in the sense of smell, which may occur before noticeable memory problems.

 

Recent research is beginning to uncover why this may happen. A 2025 study implicated early changes in the nerve fibres connecting a small brainstem region called the locus coeruleus with the olfactory system. Microglia, the brain’s resident immune cells, may contribute to the loss of these nerve fibres. These findings offer a possible explanation for why changes in smell may sometimes appear before more obvious symptoms of Alzheimer’s disease.

Go and Hug Her

She is still right there in the kitchen, in the same seat at the table. Your Ah Ma, your Nenek, your Paatti. Tell her how important she is to you, today. Because sometimes, love is simply knowing the person you have always known well enough to notice when something has quietly changed.

 

As for Alzheimer’s disease, there are neuroscientists working on it right now, quietly, the way most real progress happens, one study, one finding, one small piece of the picture at a time. Who knows, one day you could be among them, adding your own piece to a puzzle that still needs solving.

If someone you love is showing signs of dementia:

 

If you want to be part of the people researching diseases like this, one pathway for consideration is through the Bachelor of Applied Health Sciences. This programme will set the foundation for understanding how the brain works, and allow you to specialise in neuroscience alongside genetics, nutrition or embryology. You can book an appointment with our education counsellor to learn more about the programme structure, entry requirements and where it can lead.

This Alzheimer's Awareness Month, we've prepared something for you.

 

Alongside our feature story on dementia and the families living with it, our School of Biosciences is bringing you a free public webinar on brain health and healthy ageing, led by Professor Andy Hsu, Professor of Neuroscience and CEO of BrainCare360 Technology Group.

 

  • Date: 21 September 2026, Monday
  • Time: 10:00 AM – 11:00 AM
  • Platform: Microsoft Teams | Free entry
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