Early Warning Signs of Dementia

We’ve all misplaced or forgotten a thing or two from time to time. The house keys. The date and time of your next doctor’s appointment. The name of that one celebrity in a movie you saw five years ago. As we age, our brains tend to slow down and cause some temporary lapse in memory. But is that a cause for concern?

“Some people may have trouble finding a word, or briefly forget the name of a celebrity, or they may briefly forget why they came into a room. Those experiences are what we think of as typical cognitive errors, things that we all do on a fairly regular basis,” says neuropsychologist Aaron Bonner-Jackson, PhD. “A very common misconception is that those signs mean you’re inevitably on the path toward dementia, but dementia is not a normal part of aging and it’s not something we expect everyone to get.”

We know dementia affects more than 55 million people worldwide, with nearly 10 million new cases every year. Nearly one-third of all people over the age of 85 have some form of dementia, and your risk for developing dementia increases the older you get, especially if it runs in your biological family.

But dementia has a variety of causes, including Alzheimer’s disease and Parkinson’s disease, and each of these carry a wide-range of symptoms that can affect your cognitive abilities, mental health and physical health.

With so many variables at play, how do you know if your temporary lapse in judgment, memory and decision-making aren’t 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 that change has resulted in a decline in their ability to function and take care of themselves,” clarifies Dr. Bonner-Jackson.

Below, he breaks down some of the most common early signs of dementia and what you should do if you’re worried about developing the condition.

What are the early signs of dementia?

There are several different types of dementia, like Lewy body dementia and frontotemporal dementia, that each have different origins and their own set of unique symptoms. In most cases, people who develop dementia experience relatively similar symptoms early on that get worse over time.

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 often paired with a difficulty handling changes in routine, behavior and patterns of thinking.

Getting lost in familiar places

Most of us have experience with temporary misdirection where we find ourselves lost on the way to a new destination we’ve never been before. But dementia is much more serious than simply making a wrong turn.

When you have dementia, you may wander from time to time, or get confused in familiar surroundings. If you find yourself getting lost in familiar locations like your neighborhood, on your daily route to work or school, or even inside your home, that may be a cause for concern.

“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. “If you’re driving in your local neighborhood or community and you’ve made that drive several times before, but all of a sudden you’re driving along and things don’t seem familiar to you, that might be concerning.”

Forgetting short-term conversations

Occasional forgetfulness and having trouble finding the right word in a conversation is behavior we’re all familiar with. But if this happens more frequently and you find yourself forgetting conversations you had just minutes or hours ago, or you have a hard time pulling up a name of someone close to you, that may be worrisome.

“The hallmark of things like Alzheimer’s disease is that short-term memory loss, where they’re not learning and storing new memories as well as they used to, and that’s why they’ll ask the same questions over and over again,” says Dr. Bonner-Jackson.

“People can remember things from years ago with perfect clarity. They remember who they went to school with and what their teacher’s name was and what they did while they were in the military or at their first house. But it tends to be frustrating because they can’t remember what they did yesterday.”

Difficulty making decisions and keeping up with the changes

If you’re always doing things a certain way or always keeping to the same schedule, noticing subtle changes in your behavior may be more difficult. But when changes inevitably arise and they throw you off course, that’s when signs of dementia may start to creep up.

“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.”

Other common scenarios include having trouble making a new recipe, learning new tasks or driving to new places.

“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.

Having a hard time doing simple math and handling money

If you’ve been previously good with numbers but have trouble doing simple arithmetic while paying bills, counting your finances or coming up with a tip at a restaurant, these behaviors may have cause for concern. An inability to pay attention to even the smallest details or difficulty reasoning are common symptoms of dementia.

“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.”

Changes in mood or behavior

“We also often see changes in someone’s mood or behavior at the beginnings of dementia,” he adds “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 anxious.”

If you’ve never had a history with anxiety or depression but are now experiencing these conditions later in life, that may be a sign of dementia. But for someone who’s had a long family history of anxiety and depression, it may be a bit more difficult to notice signs of dementia when these mood disorders persist. But the key is to look for changes in how you feel about the world around you, the people you interact with and how you participate in social gatherings as a whole.

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. Some people feel a little more slowed down, like they’re thinking has slowed down and they may walk more slowly,” says Dr. Bonner-Jackson.

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

“Hearing loss is a factor that can predispose someone to dementia,” he continues. “If someone’s vision is poor, it’ll be harder to process information.”

What to do if you suspect you have dementia

As you can see, there are many routes to dementia and many ways it can affect your daily life. The key to diagnosing dementia is to raise your concerns with your family doctor or a healthcare provider who can refer you to a neurologist for a full workup.

Before receiving a diagnosis, your healthcare team will likely perform a number of 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.

“We would put all that information together to look and see whether we think there’s been a significant change in someone’s thinking, and whether there seems to be changes going on in their brain, the structure of their brain and how their brain is working and functioning,” explains Dr. Bonner-Jackson.

“It’s a complex process that usually involves multiple different providers and a lot of different types of testing. It’s really about assembling all the different pieces and putting it all together to give us the clearest picture we can get.”

At minimum, for a diagnoses of dementia, someone has to demonstrate a decline in their cognitive thinking and a decline in their ability to take care of themselves. We’re learning more and more about dementia each day (including rolling out a new U.S. Food and Drug Administration (FDA)-approved treatment that slows Alzheimer’s disease), but there’s still more to learn about neurological disorders. That’s why much of the focus on dementia is aiming for early prevention.

We know maintaining our physical and mental health are key to staving off dementia, and that includes exercising often, each week. Working to improve your concentration by reading, completing puzzles, and learning new languages and new skills can also be helpful in reducing the affects and likelihood of dementia.

Keeping your social circles strong and making sure you’re eating well and healthy can also have a significant, long-lasting impact, too.

“There’s a strong relationship between the gut and the brain. What we feed ourselves really does affect brain health,” says Dr. Bonner-Jackson. “People who remain social and socially connected with friends and family also have an improved cognitive well-being.”

Whichever prevention techniques you choose to embrace, it’s important to know that improving your overall health can have a direct effect on the health and longevity of your brain. And if you’re ever worried about a sudden lapse in memory, it’s never too late or too early to schedule an appointment with a healthcare provider.

“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,” says Dr. Bonner-Jackson. “That will rule out any other possible causes of thinking and behavioral changes.”