This chapter compares and contrasts Shakespeare's representation of dementia in Lear with some contemporary understandings of the condition labelled dementia. It argues that though Shakespeare proceeds from quite different constructions of what is now called dementia, and problematises Lear's state, the play chimes with some of the most advanced ideas about dementia. In considering the representation of dementia in King Lear, it is acknowledged that meanings and constructions of dementia have shifted over time. Earlier writers perceived dementia primarily in terms of loss of self. There is now an increasing recognition that people living with dementia have a capacity for change and growth. Lear's state changes as the play unfolds; he begins in one state of madness or dementia - a combination of fatal flaw and Humour modelling - but his later state is far more intensely individualised. This is a play not just about dementia, about madness or about youth and old age but about the existential human condition.