Most people who get a diagnosis of dementia get it when they’re already in the moderate stages.
Why is that? There are several reasons. It might be hard to find a specialist to do the testing. It might be hard to get your loved one to go and follow through with the testing. And most commonly, it’s hard for family members who are so close to the person to even recognize something is going on, until it has gotten worse and worse and worse and we can’t ignore it anymore.
So I want to go over 10 possible early warning signs of dementia. And I do mean possible. Someone could have one of these signs and it is not dementia. That’s why a thorough workup and evaluation is so important. If you’re still sorting out what’s normal, I go through the differences in is it dementia or normal aging.
Why Families Often Miss the Early Signs of Dementia
When I used to do assessments for dementia, it was so common for a spouse to come in and say, “I’d like to get my loved one checked out. We’re concerned about his thinking.” Usually that was only after an adult child, or somebody who didn’t come around much, came to visit and noticed the big change.
When you’re living with the person day in and day out, all of these little things are so easy to write off. We all have bad days. They’re under a lot of stress. They didn’t sleep well.
People who aren’t around a lot can walk in and notice, whoa, something is off with Dad. Those are the kinds of stories I would hear all the time.
If you notice any of these signs in your loved one, it may be time to explore formal testing. And if you’re worried about how to get your loved one to agree to it, I cover that in getting your loved one with dementia to visit the doctor.
The 10 Early Warning Signs of Dementia
Here are the 10 to watch for, in the order I’d look at them.
1. Memory Loss for Important, Well-Known Information
This is the one we’re all familiar with. But more specifically, it’s memory loss for important information, things they have known for a long, long time.
Not “oh, they forgot an appointment.” We all do that from time to time. You’re looking for something a little more significant that they forgot.
And because this is an early warning sign, it doesn’t mean they’re forgetting a lot, or that it’s happening a lot. It’s that very important, meaningful, well-learned information, and it seems a little odd that they would have forgotten it.
2. Challenges in Planning or Solving Problems
Here I’d be looking at things like paying or managing the bills, following favorite recipes, keeping up with medications and when to take them, or tracking the monthly expenses.
Again, we’re assuming they didn’t have many problems with these to begin with. You’re looking for a change. Maybe it’s taking them much longer to do, or they’re making more mistakes than normal.
3. Difficulty Completing Familiar Tasks
Along the same lines is forgetting rules or forgetting familiar tasks.
Let’s say somebody is an avid card player, and all of a sudden they’re forgetting certain rules of the game from time to time. That could be a sign.
Or maybe they often drive to a familiar place, but every now and then they have a little difficulty remembering how to get there. It’s not like they’re out there getting lost. Maybe they took a wrong turn or two.
4. Confusion With Place or Time
This might seem like, how can this be an early warning sign? If somebody doesn’t know the date or is confused about the season, that seems like a pretty big deal. And yes, that is probably something you’d see in the moderate stage.
But an earlier sign could be the little mistakes that are so easy to write off or make light of. You may have noticed this in your own loved one:
- “Oh, it’s 2022. Oh, 2024. I can’t keep track of the years anymore. They all blur.”
- “I’m retired, I don’t need to worry about that anymore.”
These tiny slip-ups get covered up so easily, and most of us would think, oh yeah, that makes sense.
5. Trouble With Visual Images and Spatial Relationships
Maybe the person seems a bit more clumsy. Maybe they’re tripping up or down the stairs, or bumping into things a little more. Maybe they’re parking uncomfortably close to the garage wall or another car.
6. New Problems With Speaking or Writing
In the early stages, you might notice this in a conversation. Things seem okay, but then in the middle of it they trail off, lose their track, and have a hard time getting back on track.
And then they might say, “Ah, don’t worry, it wasn’t important anyway.”
They can make light of it so naturally that you think, okay, fine, it wasn’t that important. But that could be an early warning sign as well.
7. Misplacing Things and Not Being Able to Retrace Steps
We all misplace things. We all forget where we put something. But most of the time, we can retrace our steps. We go back into the room and figure out what we came in for, or we take a couple of minutes and, oh yeah, that’s where the keys are.
An early warning sign of dementia is when they can’t retrace their steps. They just forgot.
8. Increased Poor Judgment
In moderate and severe dementia, we hear all the horror stories: people falling victim to scams, losing all their money, getting involved in relationships online with people who aren’t who they say they are. Those things happen to people who don’t have dementia, too.
An early warning sign could be that the person is just making more poor judgment calls than normal. Maybe they’re giving out a bit more information than they normally would, or giving more money than they normally would.
This one gets tricky, because the scammers are getting really good. I have a lot of concerns about artificial intelligence and how it can replicate somebody’s voice and talk like the person. It would be very easy to scam lots of people now. So it’s hard to tell the difference, but less good judgment is still a possible warning sign.
9. Withdrawal From Social Activities and Hobbies
This one doesn’t get a lot of attention, but I think it’s a really big one.
Maybe the person has always loved pickleball, and all of a sudden they don’t really want to go. Or they’ve always been a card player and now they’re not wanting to go anymore. They’re not really wanting to hang out with friends.
It’s so easy to put that down to depression, or fatigue, or physical problems that make it uncomfortable. All of those could be true. But this is also a really big early warning sign, and something to take seriously if you notice your loved one withdrawing.
10. Changes in Mood and Personality
Another really big warning sign that doesn’t get much attention is a change in behavior and personality. The person seems a bit not like themselves. Maybe they’re quicker to anger or get agitated. Maybe they’re more withdrawn, or anxious.
Again, it’s easy to put this down to normal aging, or “it’s normal to feel this way as you get older.” But if their personality seems to be changing, take it seriously.
For the small changes families tend to notice first, looking back, read early warning signs of dementia families often miss at first.
Wondering whether what you’re seeing is dementia is a hard place to be, especially when it’s someone you’re with every day. Inside the Care Collective, we come together every week for expert Q&As and support rooms, so you have people to talk this through with as things change. You can learn more here.
