Written by Cherilyn Cecchini, MD | Reviewed by Katie E. Golden, MDPublished on June 2, 2022
Key takeaways:
- There are many different types of dementia, but they all cause forgetfulness, trouble thinking clearly, and difficulty controlling emotions. Alzheimer’s disease is the most common type of dementia.
- Early signs of Alzheimer’s dementia include new memory loss, moments of confusion, difficulty planning or problem solving, mood changes, and social withdrawal.
- Understanding the differences between memory changes that are common as you age and the early signs of Alzheimer’s may be helpful to know if you are worried that you or a loved one may have dementia.
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It is easy to forget where you put your keys or if you locked the front door, no matter what age you are.
As you get older, some changes in your memory, attention, and thinking patterns are normal. But many people worry that their forgetfulness could be the first sign of Alzheimer’s. It can be hard to know the difference between normal, age-related memory changes and dementia.
Here, we discuss who is at risk for dementia and some of the early signs of Alzheimer’s and other types of dementia. This can help you decide if it’s time to talk to a provider about your own concerns or on behalf of a loved one.
Common symptoms that occur in the early stages of dementia
As people get older, they’re likely to notice changes in the way their brain works — especially what they are able to remember. The symptoms that occur in the early stages of dementia are similar to normal, age-related changes but with a few differences. These differences can help you know if you should be concerned about Alzheimer’s or dementia.
Here are ten early signs of Alzheimer’s and other types of dementia.
1. Memory loss
People with dementia will often immediately forget a conversation they just had or the details of an event that just happened. This looks different from being forgetful or absentminded, which is normal when performing tasks that are automatic or require little brain power.
For example, it’s easy for someone to forget where they put their car keys when they’ve been unloading groceries, since they’re more focused on the groceries. It is very different when someone has a full conversation and then seconds later has no recollection of it.
2. Challenges with planning or focusing
A person with dementia may become easily confused when trying to make plans. They may also struggle to perform or stay focused on certain tasks. For example, it could be a warning sign if someone has difficulty managing bills or balancing a checkbook.
3. Difficulty doing familiar things at home or at work
Tasks that were once performed automatically may seem challenging. For example, someone with dementia may forget how to drive to a place that they drive to every day. Or they may no longer understand the rules to a game that they’ve played many times.
4. Not knowing where you are
People with dementia may forget where they are or how they got there.
5. Confusion about time
Dementia can also cause a person to not understand how much time has gone by or what year or season it is.
6. New problems with writing or speaking
This can show up in many different ways. Someone with dementia may forget the names of common items. Or you may notice they have a tendency to stop mid-sentence or repeat themselves when speaking. These pauses and word-finding difficulties can also interrupt their writing.
7. Misplacing things
We all lose or misplace things from time to time. When someone has dementia, they lose things more frequently and also struggle with retracing their steps to help locate what’s missing.
8. Poor judgment
Someone with dementia may seem to be more disinhibited or lack judgment in a way that is not typical of their past behavior. For example, they may overspend or take financial risks when they otherwise wouldn’t have.
9. Withdrawing
People with dementia tend to withdraw from social activities, sports, and other hobbies. This can also apply to work projects.
10. Changes in mood
Dementia may cause someone to become easily upset or unusually sad. People may experience frustration, confusion, or suspicion even when they’re around friends or in a familiar setting.
These symptoms are more likely to be dementia related if there are several happening consistently and if they seem to be worsening or becoming more frequent.
Who is most likely to develop dementia?
If you are experiencing some of the above symptoms, it helps to consider your age and risk factors for Alzheimer’s.
There is no single cause of dementia. Instead, there are many different factors that may contribute to developing it, including:
- Age: This is the best-known risk factor for Alzheimer’s and other types of dementia. As age increases, the likelihood of developing dementia increases. Most people with Alzheimer’s dementia are 65 or older.
- Sex: Women are more likely to develop Alzheimer’s dementia than men. Researchers think this could be related to women living longer than men, but they’re investigating other sex-related factors.
- Family history: If you have a parent or sibling with Alzheimer’s dementia, you are more likely to develop it. Studies show that your existing risk increases by about 30% if you have a close relative with the condition. If more than one family member develops it, the risk is even greater.
- Genetics: Experts have identified some genes that increase the risk of Alzheimer’s and some, though rare, that can directly cause the disease. Tests for these genes are available, but it is recommended that you speak to your provider and a genetic counselor before considering taking them.
- History of head injury: There is a link between moderate to severe head injuries and Alzheimer’s dementia. Moderate head injuries are defined as those that cause loss of consciousness for more than 30 minutes. Severe head injuries cause loss of consciousness for more than 24 hours.
Certain health conditions and behaviors are associated with the disease, too. These include:
- High blood pressure: Having elevated blood pressure can affect the blood vessels in the brain, which can increase the risk of developing dementia.
- High cholesterol: Having elevated cholesterol levels also affects blood vessels in the brain, increasing the chances of developing dementia.
- Type 2 diabetes: While it’s not fully understood why Type 2 diabetes increases dementia risk, there is a clear association between the two.
- Depression: Studies have shown that major depressive disorder, if diagnosed before the age of 60, increases the risk of dementia. There may be an association with depression diagnosed at a later age, but more research is needed.
- Smoking: Smoking may increase the likelihood of developing Alzheimer’s for a number of different reasons. One reason is that it increases the production of molecules known as free radicals, which can damage brain cells.
How to tell the difference between normal, age-related cognitive changes and dementia
It can be difficult to tell the difference between normal, age-related cognitive changes and dementia. But there are a few things to keep in mind.
It can be helpful to consider if the change represents something new or unusual for someone. For instance, a person has always had a difficult time planning a trip or balancing their checkbook, those habits getting worse with age wouldn’t be considered a warning sign. But if they went from being good at managing their finances to forgetting how, this would be more concerning.
Another thing to consider is the impact that the change has on day-to-day life. Someone occasionally forgetting to close the garage door or the name of a distant friend isn’t too worrisome. But if a person continues to forget names, dates, or events that should be easy to remember, this could be a warning sign. This is especially true if it causes them to get lost frequently, be unable to complete tasks, need frequent reminders, or rely on notes or alarms in a way they never have before.
Conditions that can be mistaken for dementia
Some of the signs of early dementia are also seen with other conditions. So, if you see a provider about your symptoms, they will likely work to rule out these conditions first:
- Depression: This mental health condition causes persistently low mood due to chemical imbalances in the brain. Like dementia, depression can lead to problems thinking, decreased attention, loss of interest in hobbies or activities, and withdrawal.
- Vitamin B12 deficiency: This vitamin deficiency is linked to worsening memory and cognition. Since vitamin B12 levels naturally decrease as you age, this is more common in older adults.
- Hypothyroidism: This condition leads to lower levels of thyroid hormone in the body, which can cause brain fog or forgetfulness.
- Normal pressure hydrocephalus: This disorder develops when too much fluid builds up in the brain and can cause difficulty thinking and walking.
- Medication side effects: Certain medications, like anticholinergics, can cause symptoms that mimic Alzheimer’s dementia. These drugs block an important chemical in the body that is involved in thinking and memory.
- Electrolyte abnormalities: These occur when someone has too high or too low levels of essential minerals. This can happen with things like low sodium and high calcium levels in the blood.
- Infections: Certain infections can lead to temporary changes in memory and thinking, especially in older adults. Chemicals that fight off infection in the body can sometimes affect the brain. Urinary tract infections (UTIs) are a common cause of this in older adults.
- Liver disease or kidney failure: These conditions can lead to high levels of waste products in the blood, which cause delirium. This can look like dementia in an older person.
What to do if you think you, or a loved one, may have dementia
If you think you or a loved one may have dementia, a good place to start is to talk to a provider. A provider can ask questions and perform tests to help determine if anything else is going on.
Blood tests and other studies are usually the first steps in ruling out the conditions that mimic dementia. The next step is cognitive testing, during which your provider or a brain specialist (neurologist) asks questions to check things like memory, awareness, and language skills.
Depending on the results, your provider may order imaging tests of the brain. These can help them determine the next steps.
Diagnosing dementia often takes time, both to rule out other conditions and to observe how the symptoms progress.
The bottom line
The early signs of Alzheimer’s dementia can easily be confused with the normal, age-related changes in memory that almost all of us experience. Thankfully, there are some clues that you can use to help tell the difference. And, if you aren’t sure, talk to a provider. They can help you rule out other conditions and decide on the next steps for you or a loved one.
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