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Depends on what kind of dementia.
With Alzheimer's it's caused by abnormal protein buildups in the brain,
And vascular dementia is caused by conditions that damage the blood vessels in the brain, such as high blood pressure, diabetes and stroke.
Lewy Body dementia is caused by deposits of the protein alpha-synuclein in the brain.
Alcohol abuse, nutritional deficiencies, infections such as HIV, syphilis or Lyme disease, and medication side effects can also cause dementia. Along with brain injuries, brain tumors, smoking and hearing loss to just name a few causes.
So as you can see there are many causes and many different kinds of dementia. I only named 3 but there is frontotemporal , mixed dementia, and many more.
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Reply to funkygrandma59
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Some are inherited, but one is not guaranteed to get it. The gene exists in the family line, but it doesn't mean it'll get passed down to you. It can skip siblings. Sometimes what is inherited are other health issues that can lead up to dementia.

I grew up in a home with my Mom and her 2 older sisters who never married nor had kids. Those 2 lived together their entire lives, even worked in the same company (but at different jobs). They vacationed together, ate the same foods (Mediterranean diet), had the same habits and hobbies (neither smoked ever nor drank much, no partying), same friends, etc.

One got dementia (in her 80s and passed after breaking a hip at 100) and the other is just now starting to have some cognitive issues at 105. Clearly, the one Aunt must have inherited her dementia since all other conditions of their lives were the same.
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Reply to Geaton777
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The internet is your friend, here, sdlyman.
I invite you to research the exact dementia you are interested in. They vary widely. Some are easier to diagnose than others as well, as some really only diagnosed in very late stages or after death by autopsy.

Dementia is more of a "set of symptoms" than it is the disease itself, and the causes can be both in the known realm, and in the unknown (for instance we are only beginning to map genetics, and have only a clue to dietary contributors, but we DO know, or think that the cholesterol lowering drugs may also be lowering our ability to get some dementias).

You've asked an interesting question that many are answering with full massive textbooks of information that is on hitting the tip of the iceberg. What is known about our brains, both in terms of dementias and mental illness is so little, compared with what there is to learn about it.

Again, welcome to the world wide internet. You will spend many moons there looking into possible causes and cures for the many extant dementias.
Good luck.
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Reply to AlvaDeer
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