Do You Have Early Signs of Dementia?

Your risk for developing dementia increases the older you get, especially if it runs in your biological family. But how do you know if your temporary lapses in judgment, memory and decision-making abilities are just a sign of aging or if they’re early signs of dementia?

“Dementia, broadly speaking, refers to a condition in which someone has had a significant decline in their ability to think, and that change has resulted in a decline in their ability to function and take care of themselves,” clarifies neuropsychologist Aaron Bonner-Jackson, PhD.

Dr. Bonner-Jackson breaks down 10 of the most common early signs of dementia, and what you should do if you’re worried about developing the condition.

10 early signs of dementia

In most cases, people who develop dementia experience relatively similar symptoms early on that get worse over time, regardless of the kind of dementia they develop.

These symptoms can not only have an impact on your ability to think and act clearly, but they can also have an impact on your physical, mental and emotional health. In many cases, early signs of dementia are typically paired with difficulty handling changes in routine and specific behaviors and patterns of thinking.

1. Short-term memory issues

Short-term memory loss is often the earliest sign of dementia and Alzheimer’s. It’s different from occasional forgetfulness and may happen more frequently across various situations or even disrupt your activities.

For example, you may:

• Forget to finish certain tasks like turning off a light or switching over the laundry
• Forget what you’re doing at any particular time in the middle of an activity
• Have a conversation and forget what you’re talking about or the answers to particular questions

“People can remember things from years ago with perfect clarity,” notes Dr. Bonner-Jackson. “But it tends to be frustrating because they can’t remember what they did yesterday or this morning.”

2. Changes in mood or behavior

“We also often see changes in someone’s mood or behavior early in dementia,” adds Dr. Bonner-Jackson. “Someone may become less interested in things they previously enjoyed. They may be more socially withdrawn and not wanting to be around people as much. They may not find pleasure in things as much as they used to. And they could become more irritable, easily frustrated or more anxious than they were before.”

3. Getting lost in familiar places

When you have dementia, you may wander from time to time, or find yourself lost in familiar surroundings like your neighborhood, on your daily route to work or school, or even inside your own home.

“I think we tend to get most concerned when people are driving a mile down the road to a store and then they get lost coming home, when it should be presumably very simple,” says Dr. Bonner-Jackson.

4. Increased confusion

Early on, you may find yourself confused in different scenarios. Maybe you have difficulty figuring out where you are or what month it is, and are unable to solve those and other problems on your own. An inability to pay attention to even the smallest details or having difficulty reasoning adds to the confusion.

“If someone’s responsible for household bills, they may start to forget to pay them or they will pay them and then forget that they already paid and they’ll pay again, or they’ll make an error,” poses Dr. Bonner-Jackson. “We certainly hear stories where someone makes an error in how much they’re paying, and they add an extra zero, and all of a sudden they owe a lot or they’ve paid a lot more money than they owe.”

5. Difficulty responding to change

During the early stages of dementia, change can seem incredibly hard. You may experience increased fear, irritability or disorientation when faced with new challenges or obstacles, and these things may cause you to stick to routines you’re familiar with. If something shakes up your routine, you then might experience difficulty adjusting to those changes.

“A common scenario is when someone has a change in their medication regimen,” illustrates Dr. Bonner-Jackson. “Now, they have to take this new medicine and it’s out of their routine. That may be where they start to forget that they need to take it.”

6. Changes in rational judgment and spatial awareness

Someone living with dementia may experience subtle or severe changes in their behavioral patterns or sense of judgment. Sudden rash behavior — like walking across the street without looking for oncoming cars or rudely disrupting others — may become more commonplace even if you never participated in those behaviors in the past.

7. Difficulty making decisions

Feeling paralyzed by decision-making may also be an early sign of dementia, especially if you feel like you need help making decisions.

With decision fatigue, you can experience difficulties with everyday activities like:

• Picking out an outfit
• Shopping for a specific item
• Choosing between getting ready for dinner or going on a walk

“If someone is having trouble making decisions or seems easily confused by things that they normally would have been able to handle, that may be a concerning situation,” notes Dr. Bonner-Jackson.

8. Difficulty completing new or familiar tasks

One early sign of dementia is experiencing a subtle increase in difficulty while trying to accomplish everyday tasks. For example, maybe you have trouble:

• Following a recipe
• Following instructions while putting together a new piece of furniture
• Keeping track of finances, bills and budgets

Even picking up new hobbies or activities may seem more complicated than they would have in the past if you’re developing dementia.

“A person with dementia is likely to have more difficulty learning new skills or habits, which would make it harder for them to acquire a new hobby or participate in a new activity,” says Dr. Bonner-Jackson. “For example, they may struggle to retain the rules of a new card game or recall the next steps in a sewing project.”

9. Slowing down

It’s natural to slow down a little as we age, but it shouldn’t have too much of an impact on your ability to get through the day.

“Some people notice that they feel a little less coordinated,” shares Dr. Bonner-Jackson. “Some people feel a little more slowed down, like they’re thinking has slowed down and they may walk more slowly.”

10. Difficulty keeping up with conversation

Part of this slowing down often affects your ability to maintain communication. You may have trouble putting words to your thoughts, understanding what other people are saying or finding the right words for the current conversation.

Other physical symptoms of dementia may also appear in the form of vision loss or hearing loss.

“Hearing loss is a factor that can predispose someone to dementia,” adds Dr. Bonner-Jackson. “If someone’s vision is poor, it’ll be harder to process information.”

Early signs in men vs. women

Research is ongoing when it comes to determining the differences of dementia in men vs. women. We do know that Alzheimer’s, for example, affects women differently, in that they tend to decline faster than men after receiving a diagnosis — especially when they have the apolipoprotein E (APOE)-ε4 gene (which is hereditary).

In fact, two-thirds of diagnosed cases of dementia and Alzheimer’s in the United States are women. We don’t know whether these increased incidence rates occur because women tend to live longer than men or if women have a greater risk than men at the same age. But we do know that your risk for Alzheimer’s and dementia in general increases the older you become.

What to do next

The key to diagnosing dementia is raising your concerns with your primary care physician, who can refer you to a neurologist for a full workup.

Before receiving a diagnosis, your healthcare team will likely perform several tests that include:

• Testing your balance, coordination and reflexes
• Cognitive screening
• Neuropsychological testing
• Brain imaging
• Bloodwork

Taken together, these tests can help determine what, if anything, has changed inside of your brain.

“The first step would be to go to your doctor and get a referral to a neurologist or dementia assessment center and get a full workup to evaluate how you’re doing right now,” advises Dr. Bonner-Jackson. “That will rule out any other possible causes of thinking and behavioral changes.”