10 Early Symptoms of Dementia

Early signs of dementia include cognitive symptoms and changes in behavior, mood, and personality. The symptoms can be subtle at first and later progress so that people may not be able to take care of themselves.

Symptoms may indicate early dementia if they are out of character, persistent, and getting worse. It's important to see a healthcare provider if you have concerns about dementia to get a correct diagnosis.

1. Memory Loss

It's common for people to forget things, especially as they get older. However, memory loss that affects the person's daily activities, and progressively gets worse, can be a sign of dementia.

Some early signs of dementia-related memory loss include:

• Asking the same questions repeatedly

• Forgetting recent events

• Increased reliance on memory aids like written notes

2. Misplacing Items

Losing items occasionally is common for everyone, even without dementia. However, those with dementia not only lose items frequently, but they also lose the ability to retrace their steps when looking for the item.

In addition to losing items, they may leave things in unusual places, like putting a hairbrush in the refrigerator. As dementia progresses, they may also accuse others of stealing things.

3. Difficulty Solving Problems

Dementia may also be identified by a decline in problem-solving ability. Early signs include difficulty following multiple steps in directions or solving basic math problems.

This can include challenges with:

• Following a recipe with multiple steps and ingredients

• Managing a complicated medication schedule

• Balancing a checkbook

4. Losing Track of Time

People with early dementia can lose track of time easily. They may get confused about the date or the time of year. They might also have trouble understanding future plans or events that aren't happening immediately.

5. Confusion About Places and Directions

Along with trouble understanding time, people with dementia can get confused about locations. They could struggle to remember directions or locations they've visited, even familiar landmarks. They could also forget how they arrived at a particular location.

6. Problems With Communication

People with early dementia may experience new problems with following or joining in a conversation. They often have trouble expressing their thoughts in both spoken and written communication. They also struggle with vocabulary and may use the wrong name for common objects.

7. Trouble With Visual-Spatial Abilities

Dementia patients may have trouble with visual-spatial skills, or the ability to understand and analyze objects in the environment. This can cause problems with things like:

• Keeping their balance

• Driving

• Judging distances between objects

• Reading

• Determining colors or contrast

8. Personality or Mood Changes

A person with dementia may experience extreme mood swings. They may get irritable easily or cry for no obvious reason. They may also feel anxious, confused, fearful, or suspicious of others.

These emotions can be normal when they're temporary or can be explained. However, extreme mood changes that occur frequently could be a sign of dementia.

Personality changes can also be an early sign of dementia. For instance, someone who likes to be around people may start to isolate themselves. They might stop participating in activities and hobbies that they used to enjoy.

Psychological symptoms of dementia can be very hard for caregivers to cope with. It’s important for caregivers to know that the behaviors are not deliberate. They are occurring because of changes in the structure and function of the brain.  

9. Poor Judgment and Decision-Making

Those with dementia may experience poor judgment in everyday situations. For instance, they might wear winter clothes on a hot day or make poor financial decisions that they wouldn't normally make. They could also make poor decisions about personal hygiene, including not showering or washing their clothes.

10. Trouble Performing Familiar Tasks

Those with dementia may have a progressively harder time doing everyday tasks. They may have trouble getting dressed, writing a grocery list, scheduling an appointment, or remembering the rules to a favorite game.

Sometimes people who have dementia may notice these problems, and this can be frustrating or embarrassing. Often, as dementia progresses, people no longer notice their own cognitive deficits.

Early Symptoms of Specific Forms of Dementia

Various conditions can have different symptoms that indicate early dementia. Some examples include:

• Alzheimer’s disease: Early signs can include memory loss, depression, and being suspicious of others.

• Vascular dementia: People in the early stages may have memory problems or speech that becomes less fluent.

• Frontotemporal dementia: This causes changes in behavior and language problems at first.

• Pick's disease: This initially causes behavior changes, problems with thinking, and speech issues.

• Lewy body dementia: Signs include fluctuating between feeling alert or drowsy, periods of confusion, and trouble sleeping.

• Huntington's disease: This hereditary disease causes early symptoms like difficulty concentrating, memory problems, depression, anxiety, and changes in behavior or personality.

Advanced Symptoms

Over time, the effects can advance to such a degree that many people who have dementia may not be able to independently take care of themselves.  Some advanced symptoms of dementia may include the following.

Cognitive Skills:

• Confabulation, which is having false memories or saying false things to fill in for missing memory  

• Not recognizing close friends, family members, or longtime coworkers 

• Thinking they are in an earlier period of their life ("time shifting")

• Understanding fewer words or losing language skills completely

Psychological Symptoms:

• Depression 

• Agitation 

• Combativeness 

• Paranoia 

• Lack of inhibition 

• Stealing, sneaking, or lying

• Childlike self-centeredness, a lack of consideration for others

• Inappropriate behavior, such as undressing in public

• Crying or laughing uncontrollably, especially with pseudobulbar palsy (a neurological disorder that also causes loss of control of facial expressions)

• Hallucinations or psychosis, especially with Lewy body dementia or Huntington’s disease

Other Symptoms:

• Excessive sleeping or erratic sleeping habits 

• Loss of appetite or increased appetite 

• Incontinence

Diagnosis

The diagnosis of dementia is based on the clinical history and medical examination. Often, other causes of the symptoms need to be ruled out, especially if the symptoms began and progressed abruptly or unexpectedly.

A physical examination, including a neurological examination, can help identify signs of other potential causes, such as an infection, stroke (a blockage of blood flow or bleeding in the brain), or a brain tumor.

If needed, blood tests, brain imaging tests, genetic tests, or other specific testing can be done to identify medical conditions that could be causing the signs and symptoms.

Dementia screening tests and cognitive tests can help with diagnosis and with tracking changes over time. 

Common tests used in the evaluation of dementia include:

• Mini mental status examination 

• General Practitioner Assessment of Cognition (GPCOG)

• The Montreal Cognitive Assessment (MoCA)

• The Saint Louis University Mental Status Examination (SLUMS)

• Clock drawing test

These tests examine certain executive functions. They are scored and compared to standard scores to help determine whether there is an objectively measurable problem.

Cognitive tests and screenings are not used alone to diagnose any type of dementia. They are tools that are used along with a symptom history, clinical examination, and overall picture of what’s been happening.  

Smoking, high blood pressure, unhealthy cholesterol levels, uncontrolled diabetes, and heart disease can increase the risk of dementia.

Summary 

Dementia is a progressive decline in cognitive functions. There are many early signs of dementia, including memory loss, poor decision-making, problems performing simple tasks, and personality changes.

While there is no cure for dementia, there are some medical treatments that may slow disease progression and help reduce the symptoms.