Introduction: Facing the Fear of Losing the Mind

Welcome to our equipping hour this morning. We have an exciting topic—one that I think the church needs to consider and not shy away from. We’re spending the next hour pondering the Christian in dementia. I once promised to teach on this, and here we are.

One of the most frightening questions, though we rarely ask it aloud, is: What happens if I lose my mind? Not just my job or independence, but my memory, personality, and self-control. Dementia threatens not only our lifespan but seems to strike at the core of who we are—our very self. It raises fears about identity, sanctification, sin, dignity, and even God’s goodness in ways few illnesses do.

Today, I want us to think clearly, biblically, medically, and pastorally about dementia. We don’t get to ponder this as spectators; dementia will likely affect each of us personally, or someone we know and love. The church must be prepared to walk through this, to support those who have it and those caring for them. As the Bible tells us, when sin entered the world, death entered through sin. Death doesn’t only end life—it breaks our bodies along the way. Minds fail, capacities fade. Dementia is one of the most painful reminders that we live in a fallen world. It’s more than forgetfulness or aging. As minds go—our own, or those of loved ones—we groan with creation, waiting for the renewal of these broken bodies.

What Is Dementia?

We all have a sense of what dementia is, but let’s clarify. Dementia isn’t one disease; it’s not normal aging. It’s an umbrella term for a syndrome: a progressive decline in thinking that interferes with daily life—memory, judgment, language, behavior, and more. It’s not the same as delirium, which is sudden confusion from illness and is often reversible. Dementia is a slow, steady, irreversible decline in thinking, memory, judgment, language, visual-spatial skills, and even self-recognition—sometimes all the way to complete incapacity.

About one in ten Americans have dementia. That’s the odds—look around, and a significant number of us will likely end life with some form of mental incapacity. Alzheimer’s is the most common, about 60–80% of cases, but there are many kinds. Alzheimer’s is characterized by abnormal proteins in the brain—amyloid beta plaques and tau tangles—which accumulate and damage neurons. Ultimately, you lose memory, language, basic functions, even the ability to swallow, leading to death by malnutrition, dehydration, or aspiration.

There’s also vascular dementia—caused by circulation problems, not protein buildup. Your brain requires remarkable amounts of oxygen and nutrients, and if blood flow is compromised (from strokes, high blood pressure, diabetes, etc.), you get dead areas of brain and a steady progression of impairment. There are other types—frontotemporal, Lewy body, Parkinson’s-associated dementia—but the key is that dementia is not normal aging.

Theological Roots: The Fall and Its Effects

Where did dementia come from? Ultimately, the Fall. We weren’t created with minds meant to fail like this. In the garden, Adam and Eve—and those after—lived with bodies that didn’t fail so catastrophically. But when sin entered the world, death entered through sin, and our bodies began to degrade. The Fall had real effects on our physiology—cells, synapses, blood vessels, DNA, sleep, metabolism, and certainly our morality. The Fall is where dementia ultimately comes from, but there are also proximal, avoidable causes.

Causes: Proximal and Ultimate

Dementia is a disease with causes—some avoidable, some not. I mentioned amyloid plaques and tau tangles—these come from failures of cellular cleanup. The brain is physical, and like every organ, it will wear out. Vascular dementia and others are linked to high blood pressure, diabetes, obesity, smoking, sleep apnea—things that lead to dementia over years of cumulative insults. There are genetic risks—genes “load the gun,” environment and time “pull the trigger.” Aging compounded over time is a factor.

Importantly, dementia is not God’s personal judgment against specific sin. It is evidence of God’s judgment on the world, but not proof of weak faith or failed sanctification, even when evidences of sanctification seem lost. Dementia is not the loss of the image of God; the image of God isn’t stored in the hippocampus. It may be evidenced through thinking and action, but remains even when those fade.

Should Christians Try to Avoid Dementia?

How can we avoid dementia? Why should we even try? Should we just say, “If God wants me to have dementia, so be it”? I don’t think that’s right. It’s estimated that 40%—four in ten cases—could be avoided by addressing modifiable risk factors. So, as we think about the probability, we should also steward our bodies as gifts from God, maximizing our opportunity to serve and glorify Him in this short life.

If you lose your mind, it’s not the end of the world—there is an eternity to come. This life’s difficulties are not worth comparing to future glory for those who trust Christ. And yet, God gives us these bodies to honor Him. We can trust Him with whatever He allows. Don’t cling to life as ultimate, but use your body for His glory.

1 Corinthians 6:19–20 says your body is a sanctuary of the Holy Spirit—you are not your own, you were bought with a price, so glorify God in your body. It’s wrong to use the body for sin; likewise, it’s wrong to neglect your body through laziness or lack of self-control, and so miss opportunities to glorify God. That’s why it’s fitting, in a sermon on dementia, to say we should avoid it, but for reasons different from the world’s.

How to Avoid Dementia: Medical and Practical Steps

What can we do? There’s no cure—treatments may delay or stabilize symptoms, but prevention is where we focus. Even then, we’re only tweaking statistical probabilities, not exerting full control. Still, 40% of cases are likely avoidable. The most powerful tool? Exercise. Moderate exercise—20–30 minutes a day—reduces dementia risk by 38–45%. More exercise yields greater risk reduction, up to a point. A 2022 JAMA Neurology study (78,000 people, 10,000 steps daily) found a 50% risk reduction.

Next is sleep. A single night of sleep deprivation causes measurable accumulation of Alzheimer’s-related proteins. Chronic sleep deprivation increases risk further. During deep sleep, your brain’s “glymphatic” system washes out waste proteins—God designed this as a gift. Appropriate sleep (7–8 hours) is protective; too little or too much increases risk.

Hearing is another factor: every 10 dB of hearing loss increases dementia risk by 10–20%. Severe hearing loss raises risk fivefold, but hearing aids can cut risk by 50%. Social engagement and hearing input matter for cognitive health.

Diet matters too: diets rich in vegetables, whole grains, nuts, fish, and healthy fats (e.g., Mediterranean) are protective. Avoid sugars, refined carbs—they lead to metabolic problems and raise dementia risk. Obesity, diabetes, high blood pressure, and unhealthy cholesterol are all independent risk factors. Avoid head injuries, smoking, alcohol, and maintain social involvement.

Still, you can do everything right and still get dementia; there’s a heavy genetic component. These are risk reductions, not guarantees. For instance, the APOE4 gene can dramatically increase risk, but doesn’t determine destiny. We act as faithful stewards, not out of anxiety or a desire for control. If God allows dementia, we trust Him and keep doing what’s right.

Faithful Stewardship, Not Control

Keep your body as healthy as possible so you don’t miss opportunities for good works. If God takes away those abilities, He remains the same God who loved, adopted, and prepared good works for you. That good work may be simply trusting Him in your inability. These difficulties aren’t worth comparing to the coming glory. We don’t fear death; we trust God with our lives. While we have working bodies and minds, let’s use them as faithful stewards. Prevention steps are wise because our bodies are gifts, and love and good deeds benefit from strength and good thinking.

Still, odds and chances are not ultimate—God is. “The lot is cast into the lap, but its every decision is from the Lord.” Personally, I fear dementia because I fear losing control, but I must embrace—not just acknowledge—that I’m not in control.

Embracing God’s Sovereignty: James 4 and the Vapor of Life

Let’s look at James 4:13 and following: “Come now, you who say, ‘Today or tomorrow we will go to such and such a city…’ Yet you do not know what your life will be like tomorrow. You are a vapor that appears for a little while and then vanishes away. Instead, you ought to say, ‘If the Lord wills, we will live and do this or that.’” This isn’t resignation to chance; it’s confidence that the Lord, our Father, is sovereign and good. I don’t relate to Him as a capricious king but as a loving Father. Whether I live or die, whether my brain works or not, I’m where my Father wants me to be, for my good and His glory.

If you’re living for yourself, trusting in yourself, none of this applies. God is your judge, not your Father. Don’t trust yourself—you will fail, you will die soon. Trust in God through Jesus, not just to make life better, but to undo the effects of the Fall and make you a new creature, fit for eternity in a body that cannot fail.

God Rules Over Dementia

God is sovereign over dementia. Dementia is a grievous enemy from the Fall, but it’s not random, ultimate, or sovereign—God rules over every detail. He will glorify Himself by life or death, health or dysfunction, until He raises and restores these bodies. The difference between a maximally functioning human and a completely incapacitated one is small compared to the difference between us now and the glory to come. God’s sovereign purposes stand.

Scripture brings comfort: Psalm 115:3, “Our God is in the heavens; he does all that he pleases.” Daniel 4:35, “None can stay his hand.” Psalm 139:16, “All our days were written before one of them came to be.” Matthew 10:29, “Not a sparrow falls apart from the Father; you are worth more.” Isaiah 46:3–4, God carries His people into old age and through powerlessness. Exodus 4:11, Yahweh says, “Who made man’s mouth? Who makes him mute or deaf, seeing or blind? Is it not I, Yahweh?”

If your mind fails, God gave you that mind, and He will use it for His glory. His purposes for your life will not be thwarted.

Shepherding the Heart in Dementia

How do we shepherd our hearts in dementia—now and in the future? First, embrace God’s rule. He who gave His Son governs even this and will carry you. Romans 8:31–39: “If God is for us, who is against us?… Who will separate us from the love of Christ?… Neither death nor life… nor anything else will separate us from the love of God in Christ Jesus.”

Don’t worry about tomorrow; your heavenly Father knows your needs. Job said, “The Lord gave, and the Lord takes away; blessed be the name of the Lord.” God does what’s right. Dementia is not purposeless; every molecule bows to His will. We don’t always get to know His purposes, but we trust Him.

As Paul says in 2 Corinthians 4, “As our outer man wastes away, our inner man is being renewed day by day.” You are more than your physical expression—what you see is temporary; what is unseen is eternal. Losing this body is not the loss of what ultimately matters, but preparation for what’s to come. 1 Corinthians 15 says the dead body is sown in dishonor, but raised in power. The decline from our physical prime just means we’re one step closer to home.

Philippians 3:20: “Our citizenship is in heaven, and from it we await a Savior, who will transform our lowly body to be like his glorious body.” Revelation 21:4: “He will wipe away every tear. Death will be no more; neither shall there be mourning, nor crying, nor pain anymore.”

Plan Wisely—Not as If You’re in Control, but to Love Others

Planning isn’t pretending to be in control, but recognizing you’re not. Even though many recommend against genetic testing, I find it helpful—knowing your probability lets you plan better. If you know you’re likely to face dementia, prepare financially: paperwork, spending limits, financial visibility for your kids. Save now to minimize the burden on your children and caregivers later.

Prepare spiritually. As your mind unwinds, patterns may remain: Bible reading, prayer, singing, memorized verses. It’s not uncommon for someone with advanced dementia to recite hymns or verses learned in childhood. Train your children and those around you for the right reasons, and be honest about your diagnosis.

Don’t deny symptoms or justify sin. Dementia brings genuine loss of agency—sometimes intentions and actions are so disconnected from reality that what looks like sin may not be. Not all inability is sin. But don’t use inability to justify actual sin; shepherd your heart well.

Based on Scripture (especially Romans 1–2), God holds us responsible for sins we choose with a functioning will. When restraint, judgment, and moral awareness are damaged, behavior may be tragic but isn’t the same as willful rebellion. That’s helpful as you care for someone with dementia.

Caring for Those with Dementia

Be careful with life-prolonging therapies. We must not intentionally end a life because it looks hard, but we’re not obligated to pursue every intervention (feeding tubes, breathing tubes, etc.). Consider carefully the implications of withdrawing or withholding interventions. If you face these questions, there are good resources and people in the church who can help.

More important, recognize the image of God and dignity in every person. Our value isn’t from intelligence or unique abilities, but from being made in God’s image. That applies to the smartest and most capable, or to the one lying helpless in bed. Caring for those with dementia reveals true love—patient, kind, not irritable, bearing and enduring all things. Love is clearest when the object cannot repay.

Caring for someone with dementia is a true opportunity to glorify God by loving as God has loved us. Christ humbled Himself, taking the form of a slave, coming not to be served but to serve. He washed the disciples’ feet. We ought to humble ourselves and serve others in their helplessness. That’s at the heart of true religion—caring for the widow and orphan in distress.

The quality of the church isn’t measured by attendance, money, or programs, but by faithfulness—often seen in how we care for the least presentable members. “If one member suffers, all suffer together.”

Conclusion: Steward What You Can, Entrust the Rest

Let’s think about dementia, knowing it doesn’t undo our personhood. It’s not random—our Father rules over every detail. Whether our minds remain sharp or slowly fade, we are never forgotten, never separated from the love of God in Christ Jesus. So, let’s steward what we can, entrust what we cannot, and wait for the day when what’s mortal is swallowed up by life.

Let’s pray.
God, thank you for these bodies. I pray that we would glorify you with them while they work and trust you and glorify you with them when they don’t. As your body gathers with the bodies you’ve provided, I pray that we would…build each other up in love, doing the good works that you’ve prepared for us. In Jesus’ name we pray. Amen.