Is [this] a sign of dementia?

It’s a question we often hear at the Smith Alzheimer’s Center.

No matter how you fill in the blank, it’s a fair question to ask. There are numerous types of dementia, symptoms vary depending on the type and everyone is affected differently. And dementia is already hard enough to recognize as aging changes how we react, remember, recover, and more.

So how do we know what is normal aging and what isn’t? Here are some common signs for those living with dementia.

1. Short-term memory loss

One of the most recognizable signs of dementia is memory loss, particularly short-term memory. There are important distinctions within that memory loss spectrum since memory degrades as we age. Forgetting where you placed your car keys happens to all people and is typically a sign of normal aging – forgetting to pay bills when they are usually paid on time might be a more serious sign.

Individuals may forget recent events, appointments, or conversations. They might repeatedly ask the same questions, struggle to remember names of familiar people, or forget to take their medications.

2. Poor judgement

Executive dysfunction is a common sign of dementia. Someone may have difficulty making decisions of what to order at a familiar restaurant or have trouble multitasking. 

This impaired judgement can also bleed into decisions about money, hygiene, and safety. They might fall for scams, have trouble with personal finances, neglect personal hygiene, or wear inappropriate clothing for the weather.

Basic decision-making and judgement can be affected. Actions like leaving the car running, not turning the stove off, or putting car keys in the refrigerator can cause frustration and difficulty in daily life.

3. Difficulty with language

Struggling to remember the name of a common household object is a strong sign that a diagnosis is needed. People with dementia often have difficulty finding the right words, following conversations, or expressing themselves coherently. They might say a sentence that has words that relate to a topic, but are in the wrong order. They might use incorrect words or substitutes when they are having trouble remembering what an object is called. For instance, saying “the thing you call on” instead of a “phone.”

Even volume can be a symptom. Finding a louder volume when speaking can be difficult, and someone may become increasingly mute as the condition progresses. Difficulty with language can happen earlier for those with frontotemporal dementia.

4. Difficulty completing familiar tasks

Often, those with dementia will receive poor marks at their job as employers or clients can’t understand why mistakes are being made after decades of experience.

Daily activities at work or home that were once second nature can become increasingly challenging. This can include tasks like cooking a favorite recipe, managing finances or even dressing themselves in the morning. Whether it’s becoming confused about the order of steps in the activities or struggle with coordination, daily life becomes more challenging.

5. Confusion about time and place

A caregiver received a call from his wife asking how to get home. After asking where she was, he recognized the place as a restaurant across town. A little confused, he told her the directions. A few minutes later, she called back, still confused but now at a car dealership nearby.

Dementia can cause individuals to lose track of time or become disoriented about their location. They might become confused as to where to go when driving a familiar route – a simple detour may disrupt their journey.
They may forget what day or year it is, asking about a situation that was common years ago but is no longer relevant. For instance, they might ask if they can pick up their children at school when their children are grown. Wandering can also be an issue, leaving the home without an intended direction and becoming lost.

6. Changes in personality, mood, and behavior

Dementia can lead to significant personality changes. Individuals may become irritable, anxious, aggressive, or depressed, and these moods can change quickly.

As dementia progresses, individuals may withdraw from social activities and relationships, even from those they typically enjoy. They might struggle to follow conversations, feel embarrassed by their cognitive difficulties, or simply lose interest in interacting with others.

Social norms are often broken. They may sing or dance in public, or behavior may be more inappropriate, like touching or being sexually suggestive.

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All of these symptoms progress as dementia takes hold. Forgetting appointments may turn into leaving the stove on which may turn into not recognizing close loved ones.

Recognizing the signs of dementia is crucial for early diagnosis and intervention. While dementia is challenging, early diagnosis can help doctors address how to help manage symptoms, improve quality of life, and provide valuable time for planning and support.

Remember that dementia affects individuals differently, and the progression can vary widely. Early detection and appropriate care can make a significant difference in maintaining a person's independence and overall well-being.