What If Dementia Isn’t Inevitable?

Let's dare to imagine a world without this horrifying condition

Photo by Carl Hunley Jr on Unsplash

It was only a gasp, but I felt it in my whole body.

I’d asked a simple question over coffee: What’s new in dementia research? And the answer floored me.

“How about a vaccine?”

Not a tool to slow it down. Not a protocol to help us manage it. A vaccine. To stop it from happening at all.

That one word hit me harder than I expected. Maybe because dementia already feels like a looming presence in so many lives, including mine. I’ve watched it take hold of people I love. Slowly. Quietly. I’ve seen them forget names, faces, routines, entire lifetimes. I’ve seen the grief that shadows every moment. And I’ve quietly accepted that I might one day be next.

Because that’s the story we’ve told ourselves, isn’t it? That dementia is inevitable. That if we live long enough, we or someone we love will eventually have to face it.

But what if that’s not true?

Let’s take a step back.

According to the World Health Organization, over 55 million people live with dementia worldwide. That number is expected to reach 139 million by 2050. In Australia, dementia is now the leading cause of death for women and the second overall. We treat it like a statistical certainty - one of the hidden costs of longer life.

So we invest in mitigation. Memory care units. Dementia-friendly signage. Support for carers to manage the daily demands. All important. But it also reinforces a quiet belief: that decline is coming, and all we can do is soften the fall.

But then - how about a vaccine?

The reason this felt so radical isn’t because it’s a wild leap. It’s because we’ve seen it happen before.

In Abundance, Ezra Klein and Derek Thompson describe how the world mobilised in the early months of COVID. Scientists, governments and organisations didn’t work in silos. They worked together. Regulatory processes that usually took years were redesigned to happen in months. Money flowed, yes, but more importantly, the usual bureaucratic friction didn’t.

And we got a vaccine. Not eventually, but quickly. Not because we hoped. Because we decided to.

So why not dementia?

Why not treat this slow-moving, devastating condition with the same urgency? Why not believe, genuinely, that prevention is possible?

This isn’t naïve optimism. It’s about refusing to treat cognitive decline as a natural conclusion to life. It’s about imagining a future where we’re not just alive for longer, but mentally present. Laughing. Learning. Remembering.

It’s about refusing to build systems that only respond once decline begins.

Because once you stop assuming dementia is inevitable, everything else changes. You stop designing lives around loss. You start building environments that enhance cognition, invite curiosity, strengthen connection. You stop seeing care as containment. You start asking how we keep minds active, alert, and deeply alive.

This isn’t a critique of those already doing the hard work. Families. Clinicians. Carers. It’s a challenge to the rest of us. Governments. Funders. Researchers. Designers. Anyone in the position to make bold decisions.

We dared to believe a COVID vaccine could happen. And it did.

We must believe the same for dementia.

Because once you do, you stop waiting for decline and start designing for possibility.