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Symptoms and Warning Signs of Dementia

Preliminary Diagnosis of Dementia
26 February 2024
Preliminary Diagnosis of Dementia

Dementia is a gradually deteriorating disease. Major symptoms include cognitive function impairments: memory loss that damages daily function, difficulty in performing tasks such as work, cooking, financial management, speech, and communication impairment (word retrieval issues and memory recall struggles). Additionally, individuals with dementia may experience difficulties identifying people and objects, a decrease in spatial and time orientation, and diminished judgment ability. Additional symptoms include behavioral and personality changes, functional ability decrease, and difficulties in independent functioning.

Occasionally, the symptoms of dementia worsen over time. The characteristics of symptoms and the pace of their development differ among individuals based on the cause of dementia.

Although there is no cure for dementia, early diagnosis is important because it allows delaying the development of the disease, therefore if you recognize these and other symptoms in a family member or someone close to you, it is recommended to seek a diagnosis from a doctor whose field of expertise is dementia as soon as possible.

The main symptoms of dementia involve cognitive decline, having problems with memory, thinking, communication, visual perception, and reasoning. Other symptoms are behavior changes, impaired abilities to carry out daily functions, and inability to complete tasks independently.  

Symptoms of dementia usually worsen over time. Symptoms and rate of decline vary from one person to the next, and depend on the cause of dementia.  

Common symptoms of dementia  

  • Short-term memory loss (and later also long-term memory loss).
  • Difficulty completing customary tasks such as shopping, cooking, or working.
  • Language and communication problems.
  • Difficulty operating household appliances.
  • Difficulty identifying objects and people.
  • Impaired judgment.
  • Mood and behavior changes.
  • Personality changes.
  • Apathy (loss of motivation).
  • Difficulty eating, changes in appetite, refusing to eat, and difficulties swallowing and chewing.
  • Problems completing daily living activities, such as showering, dressing, taking medications, etc.  

Warning signs: when to consult a doctor?

If any of these symptoms manifest in a family member or someone close to you, it is recommended to refer them to a diagnostic evaluation performed by a doctor specializing in dementia, such as a neurologist, psychologist, or geriatric specialist. It is essential to refer the person to a diagnostic evaluation as soon as possible, as any delay in diagnosis and treatment may lead to a decline in their condition.

Early diagnosis provides the opportunity to slow down the progression of the disease.

Forgetfulness is a prevailing phenomenon, particularly in older people. There are several differences between “normal” forgetfulness and memory loss that may indicate dementia. Older adults with dementia tend to forget things often without recalling them later, for instance:

  • They forget the names of familiar people and the context in which they know them.
  • They repeat the same questions and forget the answers they have already received.
  • They struggle with remembering how to prepare familiar dishes and often forget the dishes they have eaten.

During the initial stages of dementia, while short-term memory loss occurs, long-term memory remains intact. For instance, older adults may struggle to recall what they had for breakfast, but they can vividly remember events from their childhood. At advanced stages of dementia, long-term memory is damaged as well.

The difficulty in retrieving words increases with dementia. People with dementia may forget simple words or substitute them with inappropriate ones. In advanced stages of dementia, they may speak in completely incoherent sentences.

People with dementia may get lost in their own street, unaware of their location, how they arrived there, and how to navigate back home.

People with dementia may lose their sense of time and forget what day it is or what year it is.

Difficulties such as eating, buying groceries, preparing meals, and setting the table may arise even during the early stages of dementia. These difficulties may indicate the development of dementia or a decline in function.

Examples of warning signs:

  • Sudden change in grocery shopping habits, meal hours, eating location, and nutritional habits.
  • Accumulating expired or spoiled food or buying excessive amounts of the same food.
  • Difficulty setting the table, organizing the dining area, cleaning up after meals, and washing dishes.

Manifestations of declining judgment skills in various areas may include:

  • Difficulty in grocery shopping and food preparation: for example, individuals may exhibit excessive purchasing of a particular food item while neglecting other essential groceries. They may also engage in repetitive cooking of the same dish without a valid rationale.
  • Engaging in unsafe behaviors in the kitchen, for example, forgetting to turn off the hob or stove, getting burned while preparing hot drinks, etc.
  • Difficulty getting dressed: older adults with dementia may find it difficult to appropriately dress for the weather.

Following the decline in abstract thinking ability, people with dementia struggle with calculations and financial management. For example, older adults with dementia may fill their grocery cart at the supermarket despite having a small amount of money.

During the early stages of dementia, it is crucial to plan for future incapacitation and appoint a trustee to handle financial affairs.

For information on incapacitation

Examples:

  • Difficulty operating familiar objects such as stove, hob and other electrical domestic appliances.
  • Difficulty handling money and withdrawing cash from ATMs.
  • Difficulty learning to use new and unfamiliar objects.

  • Frequent difficulty remembering the location of objects.
  • Misplacing objects in incorrect locations.
  • Storing food in improper locations, such as placing fresh vegetables in the freezer and keeping ice cream in a cupboard.

For instance, rapid shifts from calmness to tearful crying, sudden changes from anger to tranquility — all without an evident cause.

These shifts can be observed in eating patterns:

  • Older adults with dementia can forget to eat or, alternatively, engage in excessive eating.
  • Older adults with dementia may start eating their meals in the bedroom.
  • Older adults with dementia may disregard table manners and pay little attention to food spillage on their clothing during meals.

For example, a quiet and friendly person may become irritable, bothersome, and suspicious. A lively woman becomes subdued.

Older adults with dementia may exhibit a recently acquired passivity that is uncharacteristic of their previous behavior.

Many patients experience apathy and indifference, even towards their close relatives, along with a loss of interest in activities they once enjoyed.

Frequently-Asked-Questions

Dementia comprises a range of symptoms indicating gradual damage to brain functions. In the early stages, dementia is characterized by forgetfulness, difficulty retaining new information, and problems with concentration. Occasionally, behavioral problems may also manifest in the early stages of dementia.

Additional information on dementia

Forgetfulness or difficulty remembering are frequently experienced, particularly in older people. If you find that the tendency to forget starts to impact your daily functioning or interferes with your ability to carry out simple tasks, it is advisable to consult your family doctor. If required, your family doctor will refer you to a specialist in the field (a geriatrician, neurologist, or psychiatrist).

Additional information on the difference between cognitive decline and dementia

At present, there is no cure for Alzheimer's disease. However, there are various methods available to slow down its progression.

Evidence suggests that engaging in cognitive activities during the early stages of the disease can help maintain capabilities and slow down its progression. In the advanced stages, patients can benefit from a positive experience through touch and stimulation of the senses.

It is important to diagnose dementia for several reasons:

  • There are multiple diseases that can result in dementia, with Alzheimer's disease being the most prevalent among them but not the only one. Each disease has its own unique progression and treatment, and early diagnosis allows for tailored treatments to be implemented.
  • Occasionally, memory decline is not associated with dementia but with other treatable diseases such as depression, hypothyroidism, inflammation, dehydration, or the side effects of a disease. In these cases, diagnosis and treatment can play a crucial role in achieving substantial improvement or even recovery.
  • In the early stages of the disease, medication therapy can be customized to alleviate the symptoms associated with it.
  • A diagnosis will allow your family and you to prepare in advance for the expected changes due to the progression of the disease. In the early stages, you can express your preferences concerning future medical treatment, financial management, and other significant matters that are important to you. Additionally, an early diagnosis can help families cope better with the situation.

In most cases, Alzheimer's disease does not have a clear genetic component, and there is no recommendation for genetic testing to identify dementia within the family. In rare instances where Alzheimer's disease appears at an early age, there is an identified genetic factor. In this case, the gene causing the disease within the family can be detected; however, the progression of the disease cannot be prevented.

According to specialists’ estimates, a third of dementia cases are caused by risk factors associated with lifestyle habits.

For further information on dementia prevention

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