The first signs of dementia: what to look out for

What are the first signs of dementia?

Dementia rarely starts with one clear moment. It usually creeps in, with small changes that you only recognise as a pattern looking back. That is what makes the first signs hard: each one on its own also happens with ordinary forgetfulness.

Signs that often show early:

Dementia is not only about memory. In some forms other things show first, such as changes in behaviour or personality, or trouble with planning and keeping an overview, while memory still works reasonably well.

Recognising one or two things on this list need not mean anything. Poor sleep, stress, low mood and medication cause the same complaints. The difference lies in the pattern: several signs, building up over months. Read more in forgetfulness or cognitive decline: what is the difference?

I keep failing to find words. Is that a sign?

Usually not. A word on the tip of your tongue happens to everyone, and more often as you get older. Tiredness and stress make it worse. If the word does come back later, that is the ordinary pattern.

There is more reason to pay attention if:

• you often use vague words instead of the right one, such as “thingy” or “that thing”
• you use the wrong word without noticing
• you lose the thread of a conversation, or can no longer follow a story well
• it clearly gets worse over months

Changes in speech tend to be gradual, and that is exactly why a difference from a few months ago is hard to notice yourself. The speech analysis in Remind looks at pauses, pace and choice of words, and sets your recordings side by side over time. More in speech analysis as a signal for brain health.

How do I know whether my partner has dementia?

You cannot establish that yourself, and you do not need to. But you are probably the first to notice something. People whose own abilities are declining often see it less clearly, or compensate without realising.

Things partners and children often notice first:

• stories or questions are repeated
• appointments are missed, bills are left lying
• your loved one withdraws from activities or company
• familiar jobs are avoided, or left to you
• your loved one reacts with irritation or evasion when you ask about something

What helps:

• Write down concrete examples, with the date. “Forgetful” is vague; “missed the dentist on 3 October and had no memory of it” is something a GP can work with.
• Start the conversation at a calm moment. Not in the middle of a slip, but later, and from your own concern rather than as a reproach.
• Suggest going to the GP together. It is easier with two, and two sets of observations say more than one.
• You can also raise your concerns with the GP yourself. The GP can take them into account at the next contact. What the GP may tell you about your loved one in return is limited, though.

Which changes in everyday functioning are a sign?

Everyday skills say a lot about how the brain is working, because they call on memory, planning and overview all at once. Think of:

• 

  Money matters

  Paying bills, handling the bank, spotting a mistake on a statement.

• 

  Medication and appointments

  The right medication at the right time, and knowing what is in the diary this week.

• 

  Cooking and shopping

  Planning and making a meal, or working through a shopping list without buying things twice.

• 

  Getting around

  Finding the way, using public transport, being somewhere on time.

• 

  Devices

  Working the phone, the remote control or the washing machine, even after years of managing fine.

The sign is not that something goes wrong once, but that something that always worked now takes effort, is avoided, or is taken over by someone else. Doctors use questionnaires about exactly these tasks. Remind uses one to follow your everyday skills over time. More in IADL: what it is and how the A-IADL measures it.

Why it is about a pattern

One slip says little. What does say something is a line that slowly drifts away from what is normal for someone. You only see that line if you keep track of it.

Normal for you

First readingA year on