It’s not unusual to have occasional trouble finding the right word or remembering where you put things. But persistent difficulty with thinking, memory or the ability to perform everyday tasks might be signs of something more serious.

What is dementia?

Dementia is a catch-all term for changes in the brain that cause a loss of functioning that interferes with daily life. It can diminish focus, attention, language skills, problem-solving and visual perception. Dementia can also make it difficult for a person to control his or her emotions and can even lead to personality changes.

According to 2023 figures from the Alzheimer’s Association, an estimated 6.7 million Americans are living with Alzheimer’s disease, accounting for 60 to 80 percent of dementia cases, though many experts say that number is probably higher. Globally, dementia is the seventh leading cause of death, according to World Health Organization estimates.

If someone is showing signs of dementia, it’s important to see a medical expert who can conduct tests and come up with a diagnosis. Several often treatable conditions — from common infections to a vitamin deficiency — can cause dementia-like symptoms, so it’s necessary to rule them out first.

If it is dementia, you’ll want to plan how you will manage care or pursue treatment, especially as the condition progresses.

10 warning signs of dementia

Here are some symptoms to watch for.
  1. Difficulty with everyday tasks. Everyone makes mistakes, but people with dementia may find it increasingly difficult to do things like keep track of monthly bills or follow a recipe while cooking, the Alzheimer’s Association says. They may also find it hard to concentrate on tasks, take much longer to do them or have trouble finishing them.
  2. Repetition. Asking a question over and over or telling the same story about a recent event multiple times are common indicators of mild or moderate Alzheimer’s, according to the Cleveland Clinic.
  3. Communication problems. Observe if a loved one has trouble joining in conversations or following along with them, stops abruptly in the middle of a thought, or struggles to think of words or the name of objects.
  4. Getting lost. People with dementia may have difficulty with visual and spatial abilities. That can manifest itself in problems like getting lost while driving, according to the Mayo Clinic.
  5. Personality changes. A loved one who begins acting unusually anxious, confused, fearful or suspicious, or who becomes upset easily and seems depressed, is cause for concern.
  6. Confusion about time and place. If someone forgets where they are or can’t remember how they got there, that’s a red flag. Another worrisome sign is disorientation about time — for example, routinely forgetting what day of the week it is, says Jason Karlawish, M.D., a neurologist and professor of medicine at the University of Pennsylvania Perelman School of Medicine and codirector of the Penn Memory Center.
  7. Misplacing things. Someone with dementia may put things in unusual places and may have difficulty retracing their steps to find misplaced items, the Alzheimer’s Association notes.
  8. Troubling behavior. If your family member seems to have increasingly poor judgment when handling money or neglects grooming and cleanliness, pay attention.
  9. Loss of interest, or apathy. Not feeling especially social from time to time is one thing, but a sudden and routine loss of interest in family, friends, work and social events is a warning sign of dementia. A 2023 study published in the Journal of Alzheimer’s Disease found that apathy may even be a sign that someone is progressing from mild cognitive impairment (MCI) — symptoms of memory loss or thinking problems that are not as severe as dementia — to Alzheimer’s disease. People with MCI are at an increased risk of developing dementia.
  10. Forgetting old memories. Memory loss that becomes more persistent is often one of the first signs of dementia.

Different Types of Dementia

These conditions are the leading causes of dementia. People can also have mixed dementia, a combination of two or more types, such as Alzheimer’s and vascular dementia.

Alzheimer’s disease. Alzheimer’s is characterized by amyloid plaques and tangled fibers in the brain and by a loss of connections between nerve cells. Damage initially appears in the hippocampus, an area of the brain involved in memory formation, and gradually spreads.

Vascular dementia. The second most common type of dementia results from damage to the vessels that supply blood to the brain. It tends to affect focus, organization, problem-solving and speed of thinking more noticeably than memory.

Lewy body dementia. Abnormal protein deposits in the brain, called Lewy bodies, affect brain chemistry and lead to problems with behavior, mood, movement and thinking.

Frontotemporal disorders. Degenerative damage to the brain’s frontal and temporal lobes is the most common cause of dementia in people age 65 and younger. Symptoms might include apathy; difficulty communicating, walking or working; emotional changes; and impulsive or inappropriate behaviors.​​

Sources: National Institute on Aging, Mayo Clinic

Where to find help

When your loved one is displaying troubling symptoms, a trip to a primary care physician is often the first step. But to get a definitive diagnosis, you’ll need to see a specialist such as a neurologist, geriatrician or geriatric psychiatrist.

If you can’t find one, the National Institute on Aging recommends contacting the neurology department of a nearby medical school. Some hospitals also have clinics that focus on dementia.

Specialists will want to know about the patient’s medical history and habits, since modifiable risk factors like smoking and high blood pressure can play a role in dementia risk. So can a family history.

Ailments Can Mimic Dementia​

Any number of treatable conditions can cause dementia-like symptoms. Some of the most common:

  • Alcohol abuse
  • Anxiety, depression or stress​
  • Blood clots, brain infections or tumors
  • Delirium ​
  • Head injuries​
  • Kidney, liver or thyroid problems​
  • Side effects of medication​
  • Vitamin deficiencies

Source: National Institute on Aging

How is dementia diagnosed?

Some of the methods doctors use to help diagnose dementia:

  • Cognitive and neuropsychological tests assess language and math skills, memory, problem-solving and other types of mental functioning.
  • Blood tests are relatively new when it comes to diagnosing dementia and, for the moment, are limited to clinical settings. Doctors can order tests to measure levels of beta-amyloid and p-tau217, hallmarks of Alzheimer’s disease.
  • Brain scans such as MRI or PET imaging can spot changes in brain structure and function. These tests also can identify strokes, tumors and other problems that can cause dementia.
  • Psychiatric evaluation can determine whether a mental health condition is causing or affecting the symptoms.
    Genetic tests may be helpful if someone is showing symptoms before age 60. The early-onset form of Alzheimer’s is strongly linked to a person’s genes, according to the Mayo Clinic. Talk with a genetic counselor before and after getting tested.​ ​​​​​

Reference: Posted in AARP (2019), Available at: https://www.aarp.org/caregiving/health/info-2019/dementia-warning-signs.html (Accessed: 11 April, 2024)