What Is Dementia?
Dementia is not a single disease but rather an umbrella term for a decline in cognitive functioning severe enough to interfere with daily life. It may affect memory, language, reasoning, orientation, and emotional regulation. What is less often discussed is how trauma, especially unresolved trauma, can shape the experience of dementia for individuals and caregivers alike.
Trauma Across the Lifespan
Trauma does not disappear with time. Experiences such as childhood abuse, domestic violence, war, displacement, systemic oppression, or prolonged neglect can leave lasting imprints on the nervous system.
Many older adults today lived through:
- World wars.
- Forced migration or displacement.
- Poverty or institutionalisation.
- Abusive relationships.
- Chronic medical trauma.
When trauma is unresolved, it may remain stored not only as memory but as sensory, emotional, and physiological responses. These responses can re-emerge later in life, particularly when cognitive abilities change.
Memory Loss in Dementia: Why the Past Can Feel Present
A common feature of dementia is the loss of short-term memory, while long-term memories often remain intact, sometimes vividly so.
This means a person may:
- Forget what happened earlier in the day.
- Forget names, places, or recent conversations.
- Yet clearly remember events from decades ago.
For individuals with trauma histories, this can result in reliving past traumatic experiences as if they are happening now. The body responds with fear, distress, or hypervigilance, even when the present environment is safe and secure.
Dementia Can Reactivate Trauma
Research shows that people living with dementia may re-experience trauma through:
- Flashbacks.
- Nightmares.
- Emotional distress without a clear explanation.
- Behavioural changes such as agitation, withdrawal, or aggression.
Caregivers may not realise that what appears to be “confusion” is actually a trauma response.
A 2020 study by Åsa Gransjön Craftman and colleagues highlights how older adults with dementia may relive traumatic events, particularly those linked to war, abuse, or loss. Without trauma-informed care, these responses are often misunderstood or overlooked.
Dementia Itself Can Be Traumatic
Receiving a dementia diagnosis can be deeply distressing. The gradual loss of autonomy, identity, and independence may feel frightening and disorienting.
For individuals with prior trauma, dementia may:
- Increase feelings of helplessness.
- Trigger earlier experiences of powerlessness or lack of control.
- Reactivate attachment wounds.
- Intensify fear responses.
Unresolved trauma can make adapting to cognitive decline significantly more challenging.
Is There a Link Between Trauma and Dementia?
Emerging research suggests yes.
Studies indicate that long-term exposure to trauma and symptoms of post-traumatic stress may increase the risk of cognitive decline and dementia later in life. Chronic stress affects brain structures involved in memory and emotional regulation, including the hippocampus and amygdala.
Research published on ScienceDirect shows an association between trauma exposure, PTSD symptoms, and increased dementia risk. Similarly, UCLA Health has explored the possible links between unresolved trauma and neurodegenerative conditions.
While more research is needed, these findings highlight the importance of trauma-informed prevention, care, and support.
When Trauma Responses Are Missed in Dementia Care
One of the greatest risks is misinterpretation.
For example:
- A person restricting food may be labeled “forgetful,” when food restriction may be linked to past deprivation or abuse.
- Resistance to bathing may stem from past sexual trauma.
- Withdrawal or agitation may be survival responses, not behavioural “problems.”
When trauma histories are ignored, care can unintentionally re-traumatize.
How Do We Support People With Dementia Who Have Traumatic Memories?
Trauma-informed dementia care focuses on safety, dignity, and emotional validation.
Key principles include:
1. Believe the emotional experience
Even if details are inaccurate, the feelings are real. Avoid correcting or dismissing.
2. Create a sense of safety
Calm tones, predictable routines, and respectful touch matter deeply.
3. Learn life history when possible
Understanding a person’s background can prevent harm and build trust.
4. Avoid forcing compliance
Control and coercion can intensify trauma responses.
5. Use grounding and reassurance
Gentle reminders of safety, familiar objects, music, or sensory comfort can help regulate distress.
The Alzheimer’s Society emphasises responding with empathy rather than logic when traumatic memories surface.
Why Trauma-Informed Care Matters
Dementia does not erase a person’s story.
A trauma-informed approach honors the reality that many older adults carry histories of pain that deserve recognition, compassion, and care. When we view dementia through a trauma-informed lens, we move from asking “What’s wrong with this person?” to “What may have happened to them?”
This shift has the power to reduce suffering for individuals living with dementia and for those who care for them.
Final Thoughts
Trauma and dementia intersect in complex, deeply human ways. By increasing awareness, supporting research, and advocating for trauma-informed practices, we can create environments that protect dignity, promote safety, and foster compassion across the lifespan.
No one should relive their worst moments alone.
References
Alzheimer’s Society. (2024). How do I support a person with dementia who has traumatic memories? Alzheimer’s Society. https://www.alzheimers.org.uk/get-support/publications-and-factsheets/dementia-together/how-support-person-dementia-traumatic-memories
Arvanitakis, Z., & Bennett, D. A. (2019). What is dementia?. Jama, 322(17), 1728-1728.
Craftman, Å. G., Swall, A., Båkman, K., Grundberg, Å., & Hagelin, C. L. (2020). Caring for older people with dementia, reliving past trauma. Nursing ethics, 27(2), 621-633.
Champion, C. (2024). Do unresolved trauma and dementia have a link? UCLA Health.
Nilaweera, D., Freak-Poli, R., Ritchie, K., Chaudieu, I., Ancelin, M. L., & Ryan, J. (2020). The long-term consequences of trauma and posttraumatic stress disorder symptoms on later life cognitive function and dementia risk. Psychiatry research, 294, 113506.
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
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Alexis Gott completed a BSc in Psychology and an MSc in Clinical Mental Health Sciences. She has professional experience as an Assistant Psychologist within a memory service, where she worked closely with individuals living with dementia and cognitive impairment. In this role, she supported assessments, therapeutic interventions, and care planning, often with individuals whose life histories included significant trauma. Through this work, Alexis developed a strong interest in the intersection between trauma, memory, and aging. She observed firsthand how unresolved trauma can resurface later in life, particularly as cognitive decline affects emotional regulation and autobiographical memory. Her experience highlighted the importance of trauma-informed approaches within dementia care, especially in recognising behaviours that may represent trauma responses rather than solely symptoms of neurodegenerative disease.