The Borrowed Life of Frederick Fife: A Novel

Content Warning: This section of the guide contains discussion of illness and death.

Dementia is central to the novel, which is set in a nursing home. Key characters—including Bernard Greer, whom Frederick Fife is mistaken for—have been diagnosed with dementia, which is actually an umbrella term that encompasses various conditions that include cognitive impairment as well as memory loss. The majority of dementia—up to 80%—is caused by a condition called Alzheimer’s disease (“What Is Dementia?” Alzheimer’s Association, 2025). Other forms of dementia include vascular dementia and dementia associated with neurodegenerative conditions like Parkinson’s and Huntington’s.

Because dementia most commonly affects older adults, its symptoms were once misunderstood as a natural and inevitable part of the aging process but are now known to be caused by physical changes in the brain itself. Damage to the brain cells prevents them from being able to communicate with one another. This damage frequently occurs in the hippocampus—the part of the brain that controls memory—which is why both short-term and long-term memory are often affected.

Dementia occurs in stages, ranging from mild to severe. As it progresses, it significantly impacts daily life. Those with it may misplace or lose items, forget how to perform routine actions, lose track of appointments or schedules, or overlook necessary tasks.