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What are the early signs of dementia?

Quick summary

  • Dementia is not the condition itself but instead a collection of symptoms which are caused by diseases such as Alzheimer’s.
  • As people are living longer, the number of people living with dementia is increasing.
  • People can still live a fulfilling life with dementia, if they have the right support.

Dementia is an umbrella term for a collection of symptoms which revolve around loss of memory and other difficulties with cognitive function. These are caused by several conditions such as Alzheimer’s disease, lewy body dementia, frontotemporal dementia and vascular dementia. 

According to the NHS, there are over 850,000 people living with dementia in the UK and this number is increasing as people are living longer – it’s estimated that by 2025 there will be over one million people in the UK with the condition.

A dementia diagnosis can have a big impact on a person’s life – and can often be difficult to accept, for both the individual and their family/friends.

Everyone is unique, and dementia can affect people in different ways, so two people are unlikely to exhibit exactly the same early signs. But there are common indications. When you start to notice these on a regular basis, it’s probably time to open up a conversation with the affected party. 

Be patient, sensitive and calm while discussing this with your loved one. Be mindful of when you choose to bring up the conversation. Your relative or friend could take offence or get embarrassed, which may result in them being more defensive than open to a discussion.

An open dialogue is critical to you being able to take it on together, get treatment arranged in good time and put a practical plan in place for the future.

Unfortunately, dementia always worsens over time, but by planning ahead and recognising the symptoms early, you can be sure your loved one has their wishes realised when they’re no longer able to make decisions for themselves.

Symptoms of dementia

Very vague and subtle changes may not be immediately apparent, but some of the common early symptoms are outlined below. Sometimes, these symptoms are assumed to be a result of simply growing older, meaning you may not be able to recognise that there’s something wrong.

This is especially true if changes occur gradually – as they often do – resulting in them going unnoticed for some time. Even if you realise there may be a problem, there’s always the chance your elderly relative might refuse to accept this themselves, making it an even tougher subject to broach.

It‘s important to remember that dementia is characterised by a set of symptoms which are caused by various diseases or conditions, such as Alzheimer’s or vascular dementia – each of these also have their own slightly different, but specific, symptoms.

We’re going to now run through some of the critical signals that could indicate your loved one is experiencing cognitive decline. Remember, your GP is always your first port of call should you have any concerns about dementia.

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What is the Six Item Cognitive Impairment Test?

This test involves a series of six questions that can be used to score memory problems. It includes questions about the current time and date, counting backwards from 20 and remembering a name and address.

Your loved one will be given a score out of 28 that will indicate whether they have memory problems. A score of zero to seven shows no evidence of memory problems, eight to nine means there are signs of memory problems and a score of over ten suggests high evidence that memory is impaired and requires further investigation.

You can see an example here. Following a higher score in this simple test, more detailed examinations follow. An expert medical professional will discuss your results with you.

1. Memory loss

Memory loss, especially short-term memory, is, of course, the most common symptom of early dementia. If you express concerns about your elderly relative’s memory, their doctor may use a memory test such as the Six Item Cognitive Impairment Test to investigate whether they do have dementia.

2. Language problems

Difficulty in finding the right word can happen to anyone, but if you notice that your loved one frequently forgets a simple word or often substitutes the right word for an unusual one – making the conversation difficult to follow – this might be an early sign of dementia.

3. Struggling with familiar tasks

People who have dementia sometimes find it difficult to perform familiar everyday tasks that we wouldn’t usually have to think much about. For example, they might not be able to put their clothes on in the correct order or remember the steps involved in preparing a simple meal.

4. Confusion and disorientation

If your loved one has companion care, you or another carer may become aware that they don’t know what day it is or are confusing day with night. If they go out, they may be unable to find their way home or get lost in a familiar place.

5. Mood and personality changes

Everyone is susceptible to mood changes from time to time, but if your loved one begins to have rapid mood swings for which there’s no apparent reason, it could indicate the early stages of dementia. In some cases, a person who is living with dementia will appear less emotional than they previously did.

Equally, another thing to look out for is if they become particularly suspicious or irritable when it comes to people they know well. Perhaps you notice they sometimes think that a friend or family member is stealing from them, for example.

6. Withdrawing from social life

Sometimes, an early sign of dementia is when a person becomes withdrawn and apathetic, not caring about things that used to be important to them. Although we can all feel fed up with things such as social obligations or activities sometimes, if your loved one seems to have lost interest in hobbies and seems to be sleeping more than usual, it’s worth discussing your concerns with their doctor.

7. Poor judgement

Poor or decreased judgement can sometimes cause someone who is developing dementia to speak or act uncharacteristically. For example, they might dress in many layers of clothes on a hot day or get up for their morning routine in the middle of the night.

8. Losing things

We can all misplace things such as keys or spectacles from time to time. The difference with someone living with dementia is that they may put items in strange places, for example, placing a teapot in the fridge. Sometimes, when they’re unable to find the thing they have misplaced, a person with dementia may think it’s been stolen.

9. Problems with concentration

Someone with dementia may have difficulty following a conversation, or they might be unable to cope with daily tasks that require concentration, such as sorting out the correct money to pay for purchases in a shop.

What happens in the early stages of dementia?

In the early stages of dementia, a person’s day-to-day life may start to become affected by their developing symptoms – such as having issues with their memory, reduced speed of thought, behaviour and language. They’ll likely start to notice their symptoms. They’ll begin to realise how these symptoms are impacting them. They’ll maybe even realise they’re getting ill before a diagnosis. This can all be a confusing and distressing process. 

Despite the developing symptoms, generally, in the early stages of dementia, a person can continue to live independently. It’s important, however, to remember that it affects everyone differently – depending on the type of dementia, as well as things such as personality and environment.

How does dementia affect the brain?

Most types of dementia cause damage to specific parts of the brain. This means, in the early stages of dementia, often the different types can display different symptoms.

For example, frontotemporal dementia affects the frontal and temporal lobes of the brain which in turn can lead to personality changes. Whereas other types, such as Alzheimer’s, will lead to memory loss.

However, as dementia progresses, different areas of the brain will become affected. This leads to broader similarities among the varying types of the condition in the mid to later stages.

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Get help with dementia

Find dementia support in your area on the Alzheimer’s society website.

The different types of dementia

Alzheimer’s disease

Alzheimer’s disease is one of the well-known forms of dementia. The onset is usually very slow, making it difficult to determine whether or not your loved one has a problem, at least in the early stages.

Those living with Alzheimer’s usually experience difficulties in remembering names or recalling recent events. They may ask the same question repeatedly and struggle to find the correct words to use. Some Alzheimer’s patients find it difficult to cope with financial transactions, and many of them find it hard to plan or organise tasks.

Vascular dementia

Vascular dementia is the second most common form of dementia seen in the UK and is commonly triggered by a stroke or mini-stroke. Many of the symptoms are similar to Alzheimer’s, such as cognitive disorientation, memory loss and difficulty communicating, but other symptoms will also be present, depending on the area of the brain that is affected.

Many of those with vascular dementia have trouble processing new information, and struggle with reasoning and paying attention. They may experience bouts of apathy or become more emotional than usual.

Look out for changes in the way your loved one walks and moves, as this could be an indication that something is wrong. Frequent bladder problems are another indicator that your loved one may be experiencing vascular dementia.

Lewy body dementia

Those experiencing Dementia with Lewy bodies  (DLB) will show many of the most common dementia symptoms – such as problems with spatial awareness and memory loss.

If your loved one develops this form of dementia, you may see a change in their alertness, along with symptoms more commonly associated with Parkinson’s Disease, such as tremors, muscle stiffness and slower movements than usual.

Some people with DLB experience disturbances with their sleep patterns, and even visual hallucinations, while another symptom is a tendency to faint, leading to potential falls. DLB usually progresses slowly.

Frontotemporal dementia

Commonly known as FTD, frontotemporal dementia causes symptoms associated with the particular area of the brain which is affected. Some of those living with it will experience problems relating to social behaviour, while others may struggle with processing language or facts.

You may see changes in your loved one’s personality, such as an inability to behave appropriately, for example, or your loved one may lose interest in personal hygiene.

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How to get a dementia diagnosis

If you have any concerns that the changes you notice in your loved one may be early signs of dementia, it’s always worth accompanying them to see their GP. The earlier the condition is diagnosed, the sooner they can get help. It may seem difficult to comprehend, but knowing the cause of these symptoms can really be a relief because then it can be appropriately dealt with.

Although there is not a cure at present, depending on the form of dementia your loved one has, medication may help with reducing or delaying the progression of the symptoms.

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Get your GP’s perspective

Your loved one’s GP is the person who has the clearest view over how symptoms may have developed over time. They’re the first port-of-call when you suspect your loved one may have dementia. If they think your loved one’s condition is worth investigating further, they’ll invite you to a memory clinic.

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Visit a memory clinic

Memory clinics are specialist centres that diagnose dementia. Your loved one will be given a baseline assessment to establish their current memory problems. They will be offered a series of tests to check on their ability to remember facts and retain information, which will give an initial insight into their mental capabilities.

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Dealing with a dementia diagnosis

It’s inevitable to feel somewhat overwhelmed by a dementia diagnosis. Your loved one is likely to display a mixture of emotions. But help is at hand. There are a range of charities and services available to help you with in-person support networks, expert advice and legal advocacy.

Planning ahead

Following a dementia diagnosis, you should start planning ahead. Think about putting lasting power of attorney in place – this can help ensure your loved one’s wishes are acted upon even when they lack mental capacity to make big decisions themselves.

Another area you should start considering is care options. It’s best to discuss this with your loved one before their condition progresses, even if this is a difficult conversation to have.

It’s important to get an understanding of their wishes when it comes to getting extra support – they may want to continue living at home, with live-in care for example, or they may be happier going to a local care home.

It’s natural to be shocked by a dementia diagnosis. But, whether you’ve been diagnosed yourself or your loved one has faced the news, it’s crucial to maintain a positive outlook. It’s a big change, but it’s not all doom and gloom.

It’s entirely possible to live well with dementia for many years, so together it’s worth doing some research into reminiscence therapy, keeping active, eating well, investing in home adaptations or perhaps joining a group or forum to speak with other people who may be going through the same experience.

Frequently asked questions

What are the nine warning signs of dementia?

While different types of dementia will carry different early signs, there are nine which are generally most common among those with dementia:

– Memory loss

– Confusion and disorientation

– Difficulty solving problems

– Language problems

– Visual difficulties

– Losing things

– Poor judgement

– Withdrawal from social life

– Mood and personality changes

What is the first sign of dementia?

There’s no set first sign of dementia as the different types of dementia will all carry their own first sign. In addition to this the ‘first’ sign can differ depending on an individual and their circumstances and they may not notice some of the signs before they notice others. For many types of dementia, including Alzheimer’s, memory loss and personality changes tend to be the first noticeable signs – but this can differ.

What are the seven stages of dementia?

The seven stages of dementia which are discussed and recognised by many, specifically refer to the stages of Alzheimer’s progression as developed by Dr. Barry Reisberg and they are as below:

Stage 1: Not noticeable, the condition is not detectable.

Stage 2: Very mild decline in cognitive ability – there may be very slight memory problems.

Stage 3: Mild decline – family may start to notice cognitive change.

Stage 4: Moderate decline – clear symptoms are apparent such as poor short-term memory.

Stage 5: Moderately severe decline – at this stage people may need help with day to day tasks.

Stage 6: Severe decline – at this stage people with dementia will need constant supervision and professional care.

Stage 7: Very severe decline – this is the final stage of dementia in which people lose the ability to communicate or respond to their environment. They will need specialist constant care.

How do you test for dementia?

There’s no test to diagnose dementia however doctors do carry out tests which can help determine types of dementia based on a number of factors. They’ll often carry out memory or cognitive function tests as well as speaking to family and examining medical history.

If dementia is expected, it’s likely your loved one will have a series of brain scans. These can be a PET, a MEG or an MRI. A lumbar puncture, which looks at cerebrospinal fluid in the spine, can help indicate the presence of certain proteins associated with Alzheimer’s disease. All these will be examined by an expert who’ll come to a diagnosis.

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