How To Recognize Early Signs Of Dementia?
Is my loved one just getting older, or do they have Dementia?
(Dementia is a broad term - we’ll cover that more deeply in subsequent blog posts!)
Recognizing the early signs and symptoms of dementia in a loved one can be a challenging AND emotional journey. It’s a path filled with love, patience, and moments of heartbreak as you witness someone you cherish change in ways that are hard to comprehend. I've been there, and I know how difficult it can be to distinguish between normal age-related changes and the onset of any form of dementia. I can also appreciate the pit in your stomach that you feel as you start to realize that this might be much more than “normal aging”. However, understanding what to look for can help ensure you and your loved one gets the care and support they need. Below are some of the key signs to watch for, based on my experience as a family caregiver and the latest research:
Memory Loss That Disrupts Daily Life
One of the most common early signs of dementia is memory loss, particularly forgetting recently learned information. We all misplace our keys occasionally, but a person with dementia may repeatedly forget important dates or events and rely heavily on reminders (verbal), their calendar (on the counter), or family members to manage their daily life. For example, they might ask the same question multiple times within a short period, not realizing they've already received an answer.
Difficulty with Familiar Tasks
Tasks that were once second nature can become overwhelming for someone with dementia. You might notice your loved one struggling to cook a favorite recipe, manage their finances, or even remember the steps involved in getting dressed. For example, they might put their underwear on top of their pants or forget to put on their bra. It's not just about forgetting how to do something—it's about losing the ability to sequence or focus on tasks that were once routine.
Confusion with Time or Place
Dementia often causes disorientation about time and space. Your loved one might forget where they are or how they got there. They may also become confused about the day, month, or year. For instance, they might think they're living in a different decade, talk about a long deceased family member as if they just saw them, or fail to recognize familiar surroundings.
Language Difficulties
Finding the right words can become challenging for someone with dementia. You might notice them struggling to follow conversations, repeating themselves frequently, or using unusual words to describe everyday objects (e.g., calling a watch a “hand clock”). This difficulty with language can lead to frustration and withdrawal from social interactions.
In my experience, your loved one might laugh it off as a gaffe to compensate and cover-up that they were confused. My mom was a master at hiding her dementia. The key in that case is noting the frequency with which this happens.
Changes in Judgment and Decision-Making
A noticeable decline in judgment is another red flag. The one that my family noticed was around my mom’s flagrant neglect of personal hygiene (e.g. not combing her hair, nail polish left chipped when she always had beautifully manicured hands, teeth not brushed). These lapses in judgment often stem from a lack of awareness of (or care for) their appearance, inability to assess situations logically or foresee consequences. If they don’t brush their hair, that’s not a big deal. But if they stop wiping after they’ve gone to the bathroom and then use their hands to eat and groom themselves, this can quickly turn into a sanitary issue.
Financial Missteps
Money problems may be one of the first noticeable signs of dementia. We’ve all heard about the poor person who was tricked into giving away large sums of money or clicking on a link sent by email that enables someone to hack into their bank accounts. Many times the signs are more subtle, where your loved one has trouble with:
Counting change
Paying for a purchase
Calculating a tip
Balancing a checkbook
Understanding a bank statement
Writing a check
Paying with a credit card (hands over their drivers license instead)
Using a debit card (can’t remember the PIN at the ATM)
My mother was a stock broker, a profession that involved rapid fire money transactions. She knew her account balances to the penny. So this type of misstep, once I started paying attention, was a big giveaway.
Withdrawal from Social Activities
You may notice your loved one withdrawing from hobbies, work, or social engagements they once enjoyed. This withdrawal is often linked to feelings of embarrassment or frustration over their cognitive difficulties. For example, someone who loved playing cards might stop participating in their Bridge group because they can no longer follow the rules.
Or in my case, it was the exact opposite - the frequency of interaction was “annoying”. My mom started dropping in to visit me during work hours without warning. I worked from home; perhaps if I worked in an office she wouldn’t have done that. In hindsight, I think it was so that she remembered how to get to my house and to tell me she loved me as many times as she could for fear of forgetting me (she never did).
Sometimes the withdrawal is not of their own making…
One of the greatest sources of sadness for me was how my mom was treated by others her own age??!! My mom loved to make pottery. When she moved to the CCRC (Continuing Care Retirement Community), and was already exhibiting strong signs of dementia, she would go to the art room to immerse her hands in clay. Art therapy is a well-known tool to help dementia patients cope with their decline. She could no longer make the beautiful pieces that she used to - and she didn’t know how to clean up after herself anymore. And because that “inconvenienced” the other 80-something ladies in the studio, they complained and shunned her out of the art room. Like your elementary school child who is made fun of on the playground, all I wanted to do was protect her! It broke my heart to see her treated that way.
Mood and Personality Changes
Dementia doesn't just affect memory—it impacts emotions and behavior too. Your loved one might become unusually irritable, anxious, or depressed. They could also exhibit personality changes; for instance, someone who was once outgoing might become withdrawn and apathetic. Some individuals may develop paranoia or exhibit uncharacteristic behaviors.
In my mother’s case, a kind, loving and easy going person became increasingly nasty, rude, and critical. She moved in with us during Covid for 5 months. My son started hibernating upstairs, away from her, because he became her target for verbal abuse. This was devastating for him as they had always had such a close relationship. It was hard for the “kid” in him to realize that she wouldn’t do it if she could help it, and that she really loved him dearly. We will never know why she took her frustrations out on him. Looking back, with his dark hair and eyes, beard, mustache and physical build, he may have reminded her of my father - who walked out on us when I was 7 years old.
Struggling with Visual-Spatial Relationships
You may notice your loved one having trouble judging distances or recognizing objects in three dimensions — a symptom that can make driving particularly dangerous. For example, they might misjudge steps or struggle with reading maps.
This is where I “slammed” into my dementia caregiving journey. My mom had a mini stroke during a trip to/from a hairdresser’s appointment. Apparently she had been slurring her words while she was there! Amazingly she made it home safely, only to crash her car into the garage because she couldn’t navigate the spacing. We rushed her to the hospital and she was briefly on a ventilator. Following this, she needed occupational and speech therapy. Those therapists were the ones to identify that her symptoms were not all new. Looking back, her dementia had been present for some time. About 18 months before the stroke she had emergency surgery for an empyema. We have no idea how long that condition had been constricting her lung capacity, reducing oxygen to her brain. She had been diagnosed (lifelong smoker) with COPD years before, so being out of breath was not unusual. The stroke exacerbated her vascular dementia, compounding her symptoms.
Repetitive Behaviors
Repetition is another common symptom of dementia. Your loved one might repeat questions, stories, or even actions like folding the same piece of laundry over and over again. This behavior is often rooted in memory loss and anxiety.
My mom often rubbed a piece of her clothing between her fingertips; it seemed to soothe her. And then when the anxiety escalated, she would use scissors to cut her clothing (sometimes while it was on her) - leading us to have to remove scissors, knives, nail clippers, and other sharp objects from her home (when she wasn’t looking).
Unusual Eating Habits
Changes in eating habits or table manners can also signal dementia. Some individuals develop cravings for specific foods—often sweets—or lose interest in eating altogether. Others may forget how to use utensils properly or fail to recognize when food is too hot.
In my mother’s case, I started noticing that I had to throw out a lot of spoiled food and buy a lot of wine - she was drinking it like water! When we’d go out to eat, I got creative in finding ways to dilute her Chardonnay. She began to crave steak at every evening meal, which she hardly ate when I was growing up. And when she ate, she started using a knife as if it was the fork, or sometimes just ate with her fingers. Given the table manners ingrained in me from my earliest childhood memories - THAT was a big shock to my system. But because she didn’t discriminate between dull cutlery and sharp steak knives, those had to quietly disappear!
Changes in Perception and Awareness
People experiencing memory and thinking problems are often less aware of these early changes than those around them. They may have less insight into how these symptoms are disrupting their everyday life. As a result they may be highly resistant to a conversation about these changes.
Looking back, in my mother’s case, I think she was acutely aware - and petrified - of these changes. She was a master at coping and so was able to hide them far longer than was safe. In the year prior to her stroke-induced car accident, she spent a lot of time getting her affairs in order; which proved invaluable to me later. I wish that she had shared her fears with me so that we could have had conversations about what she wanted in more detail before I had to make so many (hard) decisions rapidly. But, once a mom, always a mom. She tried to protect me all the way to her last breath. More on that another time!
In solidarity,
Kate
Sources:
WHO Fact Sheet
AARP Warning Signs; and many more resources
Alzheimer’s Association 10 Signs; Tips for Caregivers; and many more resources
