Spotting early signs that could be dementia – when should you worry?

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By Dr Tim Rittman | Thursday 09 November 2023

A new year has arrived. For some, this is the time of year to reflect on both ourselves, and the loved ones we’ve recently spent time with.

If you spent time with family and friends, especially those you may not have seen for a while, you might have noticed changes in them that weren’t there before.

In its early stages, dementia can be difficult to tell apart from other conditions. And that means it can be hard to know how much to worry if you think someone might be a bit different than when you last saw them.

That’s understandable – it’s something many of us know very little about.

A recent YouGov survey, commissioned by Alzheimer’s Research UK, showed that less than half of participants (49%) could name ‘memory loss’ as an effect of dementia. And only 12% of the 2,162 participants said they knew dementia causes people to lose their independence, while nearly a quarter (22%) said they had no idea how the condition impacts people.

It’s a surprising finding, given how dementia will impact so many of us. Nearly a million people are living with it right now in the UK, and if nothing changes the condition will affect 1 in 2 of us – either by receiving a diagnosis ourselves, caring for a loved one with dementia, or both.

It is important, then, to raise awareness of early signs of dementia so people with symptoms can be referred to a memory clinic for a full assessment and an accurate, timely diagnosis. An early diagnosis means that people with dementia and their loved ones can plan for the future, access the right care and support, and consider the option of taking part in research.

As a clinician who treats people with dementia, I’m often asked about whether dementia has any tell-tale signs, and what to do if you’re worried.

So what are the signs people need to know about?

When it first starts, dementia’s signs and symptoms are often mild and not that easy to spot. Mild forgetfulness, changes to perception or the way we speak can be early indications that something is wrong. It’s really important to know that these kinds of symptoms can have other causes, such as low mood, or the side-effects of medications. But they could be early signs of dementia.

 

Problems with memory and thinking

Early on forgetfulness could be mild, affecting memory for places or things that have happened in the past. You may notice someone asking the same question in quick succession, or struggling to remember the name of objects around the house. People may find they struggle to concentrate on daily tasks, or they may find following the storyline of a TV programme difficult for example.

Another early sign is changes to perception and awareness. People experiencing memory and thinking problems are often less aware of these early changes than people around them, or have less insight into how these symptoms are disrupting their everyday life.

 

Communication

When holding a conversation you may notice pauses, problems finding the right word or with putting sentences together. These signs can be related to aphasia, a word used to describe problems with understanding words, speaking, reading, and writing. These symptoms can be caused by Alzheimer’s disease, but problems with communication can also be caused by a rarer type of dementia called frontotemporal dementia.

 

Planning and problem solving

A person with mild dementia might start missing appointments or may begin to struggle with handling their finances. General confusion (not knowing what day it is), problems with forward planning and following instructions (like shopping for and cooking dinner) may become noticeable.

 

Emotion and mood

Low mood and anxiety are common early symptoms, and people may become anxious about going to a new place or meeting people. Because changes to mood and emotions happen to all of us from time to time, and overlap with the common symptoms of depression, grief or stress, this can be a harder sign of dementia to spot.

In some types of dementia, like frontotemporal dementia, changes to behaviour – like a loss of empathy – and sense of humour, or becoming angry can be early signs too.

 

Movement

Some types of dementia can cause movement symptoms. These might affect someone before memory and thinking problems start. Signs to look out for include changes to the way we walk (gait), difficulty with coordination, increased unsteadiness, or limb stiffness.

 

Sight

Some people may begin to experience visual disturbances. These symptoms are common in Alzheimer’s disease alongside memory problems, but can be the main issues in two different types of dementia, called dementia with Lewy bodies (DLB) and posterior cortical atrophy (PCA – a type of Alzheimer’s disease). Some early visual symptoms in DLB may include hallucinations, like seeing people or objects that aren’t there even though they may look real to the person experiencing the hallucination. In PCA, the visual symptoms involve problems with judging depth or making out shapes, for example having difficulty navigating steps or stairs.

 

What to do next

While everyone’s experience of dementia symptoms will be unique, spotting early signs is important. So, what should you do if these things are happening to you, or you notice them in someone else?

If you are concerned about symptoms, speaking with your GP is the first thing to do. They will run tests to rule out other common conditions that can cause dementia-like symptoms (such as thyroid conditions or vitamin deficiencies) and make a referral for further tests if necessary.

Because dementia is caused by a number of different brain diseases, diagnosing dementia, and what type a person has while it’s mild, can make a big difference. Current treatments, which can help alleviate symptoms, can be prescribed for some forms. And although they’re not yet available in the UK, treatments that can slow the progression of Alzheimer’s disease are on the horizon, and they will work best when given in the earliest stages. So, it is becoming more and more important that we can determine who will be eligible for such medications if they become available.

(You can read more about these treatments here: lecanemab and donanemab.)

Even without drugs that change the progression of someone’s dementia, an early diagnosis is still important to ensure people receive the support, planning and care they need to live well.

You can find more information about different types of dementia and their symptoms here. If you have questions about dementia, its causes, symptoms, diagnosis or treatment you can talk to the Alzheimer’s Research UK Infoline team on 0300 111 5111 (9-5pm Monday to Friday) or email infoline@alzheimersresearchuk.org.

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10 Comments

  1. Beverley on 15th February 2024 at 6:42 am

    I would like to take part in trials to hopefully find a cure in the future even though it may not be in my lifetime

  2. Andy Allen on 15th February 2024 at 11:11 pm

    I am pleased to see that research into Alzheimer’s seems to be bearing fruit and that further progress will come and result in a cure being found – albeit not in my lifetime.

  3. Margaret Wilson on 16th February 2024 at 12:01 pm

    I would like to take part in trials but you might think lm too old at 83.

    • Everett on 16th February 2024 at 1:40 pm

      Dear Margaret,
      Please, never say you are too old. Age is but a number. I am quite sure that you are a beautiful soul, with much to offer. Whatever your dear hear desire to, do it.
      At 83, you are an inspiration. Keep on keeping on and be blessed always.

    • Alzheimer's Research UK on 16th February 2024 at 3:33 pm

      Hi Margaret,

      Thanks so much for your comment. You’re certainly not too old!

      If you’d like to find out more about taking part in research, our Dementia Research Infoline team can help. Contact details here: https://www.alzheimersresearchuk.org/about-us/contact-us/dementia-research-infoline/

      Thank you!

  4. leslie cuthbertson on 17th February 2024 at 4:30 pm

    Would like to participate in rsearch

  5. Maureen Gascoyne on 19th February 2024 at 8:44 pm

    I too would like to participate in research. My husband and I were 80 last year and celebrated our Diamond Wedding Anniversary. My husband has had Alzheimers for over six years and I am his carer. The only legacy we can leave our two children and our two grandsons is for a cure to be found when they are our age. Being a carer is exhausting and has had a negative impact on my mental health. My son is a volunteer in homes and meeting places fwhere people with dementia meet. , He continued to do this throughout the pandemic and has taken part in research. I would like to join him so that future generations can experience a dementia free life.

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About the author

Dr Tim Rittman

Neurology Consultant at the Addenbrookes Memory Clinic